Emerging Relations among Cognitive Constructs and Cochlear Implant Outcomes: A Systematic Review and Meta-Analysis

Andrew E Amini; James G Naples; Tiffany Hwa; Danielle C Larrow; Frank M Campbell; Maylene Qiu; Irina Castellanos; Aaron C Moberly

doi:10.1002/ohn.344

Emerging Relations among Cognitive Constructs and Cochlear Implant Outcomes: A Systematic Review and Meta-Analysis

Otolaryngol Head Neck Surg. 2023 Oct;169(4):792-810. doi: 10.1002/ohn.344. Epub 2023 Jun 27.

Authors

Andrew E Amini^{1

2}, James G Naples^{1

2}, Tiffany Hwa³, Danielle C Larrow⁴, Frank M Campbell⁵, Maylene Qiu⁵, Irina Castellanos⁶, Aaron C Moberly⁷

Affiliations

¹ Harvard Medical School, Boston, Massachusetts, USA.
² Division of Otolaryngology-Head and Neck Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA.
³ Division of Otology, Neurotology, and Lateral Skull Base Surgery, Department of Otolaryngology-Head and Neck Surgery, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA.
⁴ Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts, USA.
⁵ Biotech Commons, Johnson Pavilion, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
⁶ Department of Otolaryngology-Head and Neck Surgery, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA.
⁷ Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA.

PMID: 37365967
DOI: 10.1002/ohn.344

Abstract

Objective: 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 systematically evaluates whether cochlear implants in adult patients lead to cognitive improvements and investigates the relations of cognition with speech recognition outcomes.

Data sources: A literature review was performed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Studies evaluating cognition and cochlear implant outcomes in postlingual, adult patients from January 1996 to December 2021 were included. Of 2510 total references, 52 studies were included in qualitative analysis and 11 in meta-analyses.

Review methods: Proportions were extracted from studies of (1) the significant impacts of cochlear implantation on 6 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 postoperative performance on 4 cognitive assessments.

Results: Only half of the outcomes reported suggested cochlear implantation had a significant impact on cognition (50.8%), with the highest proportion in assessments of memory & learning and inhibition-concentration. Meta-analyses revealed significant improvements in global cognition and inhibition-concentration. Finally, 40.4% of associations between cognition and speech recognition outcomes were significant.

Conclusion: Findings relating to cochlear implantation and cognition vary depending on the cognitive domain assessed and the study goal. Nonetheless, assessments of memory & learning, global cognition, and inhibition-concentration may represent tools to assess cognitive benefit after implantation and help explain variability in speech recognition outcomes. Enhanced selectivity in assessments of cognition is needed for clinical applicability.

Keywords: cochlear implantation; cognition; sensorineural hearing loss; speech recognition.

Publication types

Meta-Analysis
Systematic Review
Review
Research Support, N.I.H., Extramural

MeSH terms

Adult
Cochlear Implantation*
Cochlear Implants*
Cognition
Hearing Loss, Sensorineural*
Humans
Speech Perception*

Abstract

Publication types

MeSH terms

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