Central auditory maturation and behavioral outcomes after cochlear implantation in prelingual auditory neuropathy spectrum disorder related to OTOF variants (DFNB9): Lessons from pilot study

PLoS One. 2021 Jun 7;16(6):e0252717. doi: 10.1371/journal.pone.0252717. eCollection 2021.

Abstract

The cortical auditory evoked potential (CAEP)-based P1 component acts as a biomarker for cochlear implantation (CI) outcomes in children with auditory neuropathy spectrum disorder (ANSD). To date, early intervention primarily before the age of two years and six months of CI usage is necessary and sufficient to achieve age-appropriate cortical maturation and good prognosis. However, varying degrees of neural dyssynchrony, resulting from the etiological heterogeneity of ANSD, may preclude uniform application of this hypothesis to ensure auditory cortical maturation. Thus, a focused evaluation of those carrying OTOF variants, which may be the salient molecular etiology of prelingual ANSD, would circumvent the issue of heterogeneity. Here, we sought to provide a much better understanding of the brain perspectives (i.e., P1 maturation) in OTOF-associated ANSD subjects and set the stage for an optimal strategy to enhance language development. We conducted a preliminary study comprising 10 subjects diagnosed with OTOF-related ANSD who underwent CI by a single surgeon and subsequently underwent measurements of the P1 component. We observed that DFNB9 subjects who received CI after 2 years of age exhibited "absent" or "anomalous" P1 components that correspond to delayed language development. However, timely implantation, as early as 12 months of age per se, might be insufficient to achieve age-appropriate cortical maturation of DFNB9 in cases with six to seven months of device use. This suggests the importance of sustained rehabilitation in DFNB9 than in other etiologies. Indeed, an additional follow-up study showed that a reduction in P1 latency was linked to an improvement in auditory performance. Collectively, our results suggest that central auditory maturation and successful outcome of CI in DFNB9 may have more demanding requirements, that is, earlier implantation and more sustained rehabilitation. We believe that the current study opens a new path toward genome-based neuroimaging in the field of hearing research.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Auditory Cortex / growth & development*
  • Auditory Cortex / physiopathology
  • Child, Preschool
  • Cochlear Implants / adverse effects*
  • Evoked Potentials, Auditory
  • Female
  • Hearing Loss, Central / genetics
  • Hearing Loss, Central / physiopathology
  • Hearing Loss, Central / therapy*
  • Humans
  • Infant
  • Language Development*
  • Male
  • Membrane Proteins / genetics*
  • Mutation

Substances

  • Membrane Proteins
  • OTOF protein, human

Supplementary concepts

  • Auditory neuropathy

Grants and funding

This research was supported by the SNUBH Research Fund (no.00-2020-13-2018-015, 00-2020-13-2016-014, and 00-2020-13-2015-019 to B.Y.C) and Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Education (NRF-2018R1A2B6004788 to J.S.K).