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Otology/Neurotology

Emerging Relations Among Cognitive Constructs and Cochlear Implantation

Sunday, October 1, 2023
1:12 PM - 1:18 PM East Coast USA Time
Location: 104BC

    Presenting Author(s)

  • James G. Naples, MD

    Assistant Professor
    Beth Israel Deaconess Medical Center/ Harvard Medical School
    Needham, MA, United States

    • Co-Author(s)

  • Andrew E. Amini, BS

    Medical Student
    Harvard Medical School
    weston, MA, United States

    • Co-Author(s)

  • Tiffany P. Hwa, MD

    Assistant Professor
    University of Pennsylvania Health System
    Philadelphia, PA, United States

  • DL

    Danielle R. Larrow, MD

    Resident
    Massachusetts Eye and Ear Infirmary
    Boston, MA, United States

  • IC

    Irina Castellanos, PhD

    Assistant Professor, Department of Otolaryngology
    The Ohio State University
    Columbus, OH, United States

    • Senior Author(s)

  • Aaron C. Moberly, MD

    Associate Professor of Otolaryngology
    Vanderbilt University Medical Center
    Nashville, TN, United States

Disclosure(s):
Andrew E. Amini, BS: No relevant relationships to disclose.
James G. Naples, MD: No relevant relationships to disclose.
Aaron C. Moberly, MD: No relevant relationships to disclose.
Introduction: Hearing loss has a detrimental impact on cognitive function. However, there is a lack of consensus on the impact of cochlear implants on cognition. This review and meta-analysis evaluates whether cochlear implants in adults leads to cognitive improvements and investigates the relations of cognition with speech recognition outcomes.

Methods: A systematic literature review was performed on studies evaluating cognition and cochlear implant outcomes in post-lingual, adult patients between January 1996 through May 2021. Of 2,510 total references, 52 studies were included in qualitative analysis and 11 in meta-analyses.

Proportions were extracted from studies of (1) significant impacts of cochlear implantation on six cognitive domains and (2) associations between cognition and speech recognition outcomes. Meta-analyses were performed using random-effects models on mean differences between pre- and post-operative performance on four cognitive assessments.

Results: Half of outcomes (50.8%) reported suggested cochlear implantation had a significant impact on cognition with the highest proportions in assessments of memory & learning and inhibition-concentration. Meta-analyses revealed significant improvements after implantation in two tests of global cognition: MMSE (+0.86, p = 0.02) and MoCA (+0.83, p = 0.03), and one test of inhibition-concentration: TMT-B (11.67s, p = 0.004). Finally, 40.4% of associations between cognition and speech recognition were significant.

Conclusions: Findings relating cochlear implantation and cognition vary based on cognitive domain assessed and study goal. Nonetheless, assessments of memory & learning, global cognition, and inhibition-concentration may be valuable in assessing cognitive benefit after implantation and help explain variability in speech recognition outcomes.