Personalising Cochlear Implant Healthcare: Translating the Panoramic ECAP Method from laboratory to clinic

Cochlear Implants are arguably the most successful neuro-prosthetic device in existence today and can provide a sense of hearing to d/Deaf individuals by directly stimulating their auditory nerve. Each cochlear implant patient has a unique story and hearing status, and the ease with which they can communicate with their devices varies from person to person. This underlies a need for personalised hearing healthcare to maximise the hearing potential for individual users. The Panoramic ECAP Method – or ‘PECAP’ – is a research tool that leverages objective measurements of neural responses to a cochlear implant and provides detailed estimates of variation in neural-activation patterns along the length of the cochlea. Essentially, it provides a fingerprint that captures interaction between an individual patient’s cochlea and their implant. In the future, this detailed information could be leveraged to optimise the software of their cochlear implant and enable them to better engage with the auditory world around them.

We have shown previously that PECAP’s estimates of neural-activation patterns are valid: it can detect temporary, localised areas of reduced neural responsiveness as well as identify localised increases in spread of electrical current. We have also taken steps towards clinical applicability by reducing the time required to run the test from 45 minutes to less than 10 minutes. However, the tools for collecting and analysing this data have thus far been implemented only in a research format and require computer programming skills to use. This CIND-funded project was instrumental in funding developments from research software into a platform that can be used in a clinical environment without the need for advanced technical skills. We developed a web-based application that has two functions: (1) it allows users to download patient-specific configuration files and collect PECAP data from users of Cochlear © devices using the clinical software, and (2) it allows users to upload previously-collected PECAP data into an analysis program that provides estimates of neural-activation patterns for individual cochlear-implant patients. The target audience is clinical professionals such as audiologists that would be interacting with the cochlear-implant patients in a hearing healthcare environment. It can also be leveraged by external research groups who are interested in using the method, and provides a platform for reproducible science as the analysis function is static. A number of research and clinical collaborators have provided feedback throughout the development process so that it was possible to adjust the application iteratively to meet their needs.

The support of CIND for this project has already provided us with sufficient momentum to secure a second grant that is funding development of more efficient and user-friendly offline data-collection platforms for all three major cochlear-implant manufacturers. Future plans for this project will involve additional grant applications as well as discussions with cochlear-implant manufacturers to investigate the possibility of incorporating PECAP into their clinical software, and discussions with clinicians to determine the best route for integration into standard clinical practice. Overall, we hope to employ this unique precision medicine tool to optimise cochlear-implant software for individual users, and maximise their speech understanding potential to enable them to better engage with the auditory world.

Dr. Charlotte Garcia

Post-doctoral Research Associate at the MRC Cognition and Brain Sciences Unit