Virtual reality (VR) headsets and immersive games may transform the lives of young people with cochlear implants, thanks to a new Programme Grant for Applied Research funding from the National Institute of Health and Care that has recently recruited its 100th clinical trial participant.
The young people – aged 8 to 16 years – all have severe to profound hearing loss and use cochlear implants in both ears (bilateral) to make the sounds around them clearer. Over 400 children are fitted with bilateral cochlear implants every year in the UK alone, costing about £40,000 per patient.
Cochlear implants bypass damaged portions of the ear and directly stimulate the auditory nerve through small electrodes, providing clearer sound and better understanding of speech. To work effectively, however, the brain must be trained continuously to adapt to, and recognise, the sounds that it is picking up.
Many bilateral cochlear implant users report difficulties with ‘spatial hearing’ – or using information about where sounds come from – making it hard for them to listen in noisy environments.
“When we asked teenagers with bilateral cochlear implants about their hearing, they said their ears felt ‘lop-sided’ – they didn’t hear balanced sounds across both ears. This might be so bad that they took one implant out altogether,” explained BEARS Lead Investigator Deborah Vickers, Principal Research Associate at The University of Cambridge (Clinical Neurosciences).
“This is a huge challenge for young people at a critical stage in their lives.”
The BEARS (Both EARS) training package has been developed under the lead of Imperial College London’s Lorenzo Picinali and uses a series of specialised VR games that challenge the young people to localise sounds around them and train their brains to use the information from both cochlear implants working together. Co-led by Dan Jiang of Guy’s and St Thomas’ Foundation Trust, it involves collaborators from five universities with 11 clinical sites taking part in the clinical trial.
The BEARS clinical trial is recruiting 384 young people. It will compare the effects of using BEARS training at home for at least one hour a week over a three-month period against receiving usual care. The young people are also followed up at 12 months to see if any initial effects for improvements in speech perception and spatial hearing are maintained.
BEARS training includes a range of VR games, for example, target practice with levels getting harder as visual cues are removed. “Eventually, you just have to shoot in the direction where the sound is coming from, so it’s all about training and localisation and using the two ears together,” said Debi. Another game involves taking orders from customers in a noisy pizza parlour.
“It’s a much more interesting way for young people to do their hearing rehabilitation and enables them to take control.”
Results from the clinical trial are not expected until 2026 but could potentially be life changing for young people with hearing loss, equipping them for the next stage of their lives, such as starting work or continuing in education, with hearing that is as natural as possible.
The research may also pave the way for similar hearing rehabilitation programmes for older patients or those using different types of hearing devices, such as hearing aids.
“Many adults with bilateral implants – and even some with hearing aids – are interested in taking part. Going forwards, this could be useful training for a large range of people with hearing devices,” concluded Debi.
For more information or to find out how to take part in the trial, please see the NIHR website. (opens in a new tab)