Impact of Music Therapy on Speech Intelligibility in Noise With Cochlear Implants

Overview

The aim of this clinical study is to investigate whether six months of music therapy immediately after CI implantation helps to improve speech intelligibility in noise. To investigate the effect of music therapy, a randomized study will be conducted with a "start group A" and a "delayed group" B (control group 1). Group A will start six months of music therapy immediately after cochlear implantation, group B six months later. A further control group 2 will not receive any music therapy. The speech intelligibility values resulting from the OLSA sentence test will be compared between the three groups after six and twelve months.

Detailed description

Improved speech perception is a main objective for any hearing rehabilitation using hearing devices. Even more challenging is speech comprehension in noisy environments.

Music therapy is one of the approaches that can assist users with achieving better performance in situations of difficult listening comprehension such as speech perception in noisy environments. One such music therapy concept developed in Heidelberg is based on the parallelism of language and music, whereby targeted training using musical parameters such as rhythm, pitch and timbre can have an impact on the ability to perceive speech. At present, the fact that music therapy can help improve speech intelligibility is primarily based on research with normal hearing listeners.

Nowadays, cochlear implant technology has the primary goal to restore functional hearing and speech perception in people with bilateral severe-to-profound sensorineural hearing loss. Good results will be achieved by post lingually deafened CI users regarding the understanding of open-set sentences presented in quiet. But our surroundings are rarely quiet. Therefore, the goal of good rehabilitation must be to ensure that CI users also can cope well in our noisy environment. Music therapy is thus intended to be the crucial piece in the puzzle that enables such understanding in noisy situations.

This study aims to investigate the benefits of music therapy for cochlear implant users in terms of their speech intelligibility performance in noise. This is an explorative study to determine suitable parameters such as the time point of starting the music.

Interventions

• Other music therapy after Cochlear Implantation
  The music therapy is specially designed for the rehabilitation of CI-patients. It focuses on learning to distinguish different sound sources, especially when they occur at the same time. Training involves familiarization with different aspects of music such as rhythm, melody, and pitch while at the same time also getting to know the sound of different musical instruments, including singing. The training is also aimed at learning to concentrate on spoken instructions while the music is going on.
• Other no music therapy after Cochlear Implantation
  Group C consists of persons who do not receive any music therapy after Cochlear Implantation.

Primary outcome measures

• Speech recognition threshold (SRT50) six month after Cochlear Implantation [Time frame: six month after Cochlear Implantation]

Secondary outcome measures (3)

• values of SRT50 of group A and B at twelve months [Time frame: twelve months]
• Values of SRT50 of all groups at 12 months [Time frame: 12 months]
• subjective improvements of speech intelligibilty [Time frame: 6 and 12 months]

Eligibility criteria

Inclusion criteria

• Patient aged between 18-85 years
• Patients who undergo a new CI Implantation
• Patients who speak German as their main language

Exclusion criteria

1\. Patients with congenital deafness

Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.

Healthy volunteers: No

Study design

Allocation

Randomized

Model

Parallel assignment

Masking

Open label

Primary purpose

Treatment

Study locations

Switzerland · 1 center

• Lucerne Cantonal Hospital — Lucerne

Publications

• Digeser F, Hast A, Hessel H, Hoppe U (2008): Einfluss von Obertönen auf die Frequenzdiskrimination bei Cochlear Implant Trägern
• Wagener KC, Kühnel V, Kollmeier B (1999b) Entwicklung und Evaluation eines Satztests für die deutsche Sprache III: Evaluation des Oldenburger Sprachtests. Z Audiol 38:86-95.
• Wagener KC, Kühnel V, Kollmeier B (1999a) Entwicklung und Evaluation eines Satztests für die deutsche Sprache I: Design des Oldenburger Satztests. Z Audiol 38:4-15.
• Schuppert M, Munte TF, Wieringa BM, Altenmuller E. Receptive amusia: evidence for cross-hemispheric neural networks underlying music processing strategies. Brain. 2000 Mar;123 Pt 3:546-59. doi: 10.1093/brain/123.3.546. PMID 10686177
• Schauwecker N, Patro A, Holder JT, Bennett ML, Perkins E, Moberly AC. Cochlear Implant Qualification in Noise Versus Quiet: Do Patients Demonstrate Similar Postoperative Benefits? Otolaryngol Head Neck Surg. 2024 May;170(5):1411-1420. doi: 10.1002/ohn.677. Epub 2024 Feb 14. PMID 38353294
• Parbery-Clark A, Strait DL, Anderson S, Hittner E, Kraus N. Musical experience and the aging auditory system: implications for cognitive abilities and hearing speech in noise. PLoS One. 2011 May 11;6(5):e18082. doi: 10.1371/journal.pone.0018082. PMID 21589653
• Patel AD. Why would Musical Training Benefit the Neural Encoding of Speech? The OPERA Hypothesis. Front Psychol. 2011 Jun 29;2:142. doi: 10.3389/fpsyg.2011.00142. eCollection 2011. PMID 21747773
• Petersen B, Mortensen MV, Gjedde A, Vuust P. Reestablishing speech understanding through musical ear training after cochlear implantation: a study of the potential cortical plasticity in the brain. Ann N Y Acad Sci. 2009 Jul;1169:437-40. doi: 10.1111/j.1749-6632.2009.04796.x. PMID 19673820

Identifiers

NCT: NCT06734897 · Musiktherapie_Erwachsene

Primary sources (government registries)

• ClinicalTrials.gov (US NIH)

View this study on ClinicalTrials.gov ↗