# Neural Encoding and Auditory Processing of Electrical Stimulation in Pediatric Cochlear Implant Users

> **NIH NIH R01** · OHIO STATE UNIVERSITY · 2022 · $394,334

## Abstract

PROJECT SUMMARY/ABSTRACT
 Cochlear nerve deficiency (CND) refers to a small or absent cochlear nerve (CN) as revealed by high-
resolution magnetic resonance imaging. Cochlear implantation has been used as a treatment option for children
with CND for nearly two decades. Due to the lack of understanding of how electrical stimulation is encoded and
processed in their auditory system, there is still no evidenced-based clinical practice for managing this unique
patient population. To further complicate matters, more than half of children with CND cannot provide reliable
behavioral responses despite their age due to severe comorbidities. As a result, clinicians often use a combined
“one-size-fits-all” and “try-and-see” approach to program cochlear implant (CI) speech processors for children
with CND. This practice typically results in stimulating all intra-cochlear CI electrodes with similar programming
parameters. However, recent work from our lab showed that the likelihood of measuring CN neural responses
in children with CND reduced as the stimulating CI electrode site moved from the base to the apex of the cochlea.
This unique response-deterioration pattern is not observed in children with normal-sized CNs. In addition, our
compiling preliminary data show that information transmitted by CI electrodes with no measurable CN response
is only adequate for auditory detection but not sufficient for auditory discrimination, which explains why the
majority of children with CND do not make satisfactory progress in speech and language development despite
good auditory detection thresholds with their CIs. These new findings suggest that the current clinical practice is
unlikely to provide appropriate CI programming settings for this unique patient population. Therefore, there is an
urgent need to develop objective clinical tools for optimizing CI settings for individual children with CND. As the
first step toward developing such objective clinical tools, this study aims to better understand neural encoding
and processing of electrical stimulation in both the CN and the central auditory system in implanted children with
CND. Aim 1 will compare effects of changing pulse-phase duration, inter-phase gap and pulse rate on neural
representation of electrical stimulation in the CN between children with CND and children with normal-sized CNs.
Aim 2 will determine effects of variation in CN neural survival on cortical sensitivity to amplitude modulation and
electrode discrimination in children with CND and children with normal-sized CNs. Results of this study have
high scientific significance because they will establish how variations in neural survival of CN fibers affect neural
encoding of electrical stimulation in the CN, as well as how variations in the peripheral input affect cortical neural
encoding and processing of electrical stimulation. Results of this study also have high clinical significance
because they will 1) provide scientific evidence for identifying...

## Key facts

- **NIH application ID:** 10378134
- **Project number:** 5R01DC017846-04
- **Recipient organization:** OHIO STATE UNIVERSITY
- **Principal Investigator:** Shuman He
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $394,334
- **Award type:** 5
- **Project period:** 2019-04-01 → 2025-03-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10378134

## Citation

> US National Institutes of Health, RePORTER application 10378134, Neural Encoding and Auditory Processing of Electrical Stimulation in Pediatric Cochlear Implant Users (5R01DC017846-04). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10378134. Licensed CC0.

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