Abstract
Cochlear implants (CIs) have been remarkably successful at restoring speech perception for severely to profoundly deaf individuals. Despite their success, several limitations remain, particularly in CI users’ ability to understand speech in noisy environments, locate sound sources, and enjoy music. A new multimodal approach has been proposed that uses haptic stimulation to provide sound information that is poorly transmitted by the implant. This augmenting of the electrical CI signal with haptic stimulation (electro-haptic stimulation; EHS) has been shown to improve speech-in-noise performance and sound localization in CI users. There is also evidence that it could enhance music perception. We review the evidence of EHS enhancement of CI listening and discuss key areas where further research is required. These include understanding the neural basis of EHS enhancement, understanding the effectiveness of EHS across different clinical populations, and the optimization of signal-processing strategies. We also discuss the significant potential for a new generation of haptic neuroprosthetic devices to aid those who cannot access hearing-assistive technology, either because of biomedical or healthcare-access issues. While significant further research and development is required, we conclude that EHS represents a promising new approach that could, in the near future, offer a non-invasive, inexpensive means of substantially improving clinical outcomes for hearing-impaired individuals.
Highlights
Cochlear implants (CIs) are one of the most successful neuroprostheses, allowing those with severeto-profound deafness to access sound through electrical stimulation of the cochlea
Electro-Haptic Enhancement of CI Listening approach uses “electro-haptic stimulation” (EHS)1, whereby the electrical CI signal is augmented by haptic stimulation, which provides missing sound-information
In the following three sections of this review, we first examine the evidence of EHS benefits to CI listening, before reviewing the potential for a new generation of haptic aids to support those who are unable to access hearingassistive devices
Summary
Cochlear implants (CIs) are one of the most successful neuroprostheses, allowing those with severeto-profound deafness to access sound through electrical stimulation of the cochlea. These cues have been found to provide similar benefit to speech-in-noise performance for CI users when provided through haptic (Huang et al, 2017; Fletcher et al, 2019, 2020b) or auditory (Brown and Bacon, 2009) stimulation Providing both amplitude envelope and F0 cues together has been shown to facilitate better speech recognition than providing either alone, as each provides different information (Summers and Gratton, 1995; Brown and Bacon, 2009). This condition would appear to be well met in many EHS studies, where both audio and haptic signals were temporally complex and highly correlated
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