09-12, 10:45–11:45 (Europe/Istanbul), Audiology 2
The effectiveness of cochlear implants (CIs) is largely dependent on the capacity of the central auditory system to adapt and reorganize in response to artificial electrical stimulation. This neural plasticity is essential for the accurate interpretation of speech signals in CI users. Repetitive transcranial magnetic stimulation (rTMS), particularly when targeted to the auditory temporal cortex, has shown promise as a neuromodulatory intervention capable of enhancing such plasticity. In this context, the present pilot study explores the potential of rTMS to modulate early auditory processing, as measured by the Frequency-Following Response (FFR)—a neurophysiological marker of the brain's ability to encode complex acoustic signals.
This study aims to assess whether high-frequency rTMS (10 Hz) applied over the left temporal cortex in adult CI users can influence the neural encoding of both consonant and vowel stimuli—specifically /da/, /ga/, /ba/, and /ia/—as indexed by changes in FFR measures. The broader goal is to determine whether this modulation may contribute to improved speech perception outcomes in individuals with limited CI experience.
Participants within the first 12 months of CI activation are randomized into two groups: active rTMS combined with auditory rehabilitation, and sham stimulation with rehabilitation. FFRs are recorded in response to synthetic syllables representing transient (/da/, /ga/, /ba/) and steady-state (/ia/) stimuli at three time points: baseline, immediately post-intervention, and one month later. Complementary behavioral assessments include speech-in-noise perception (via the Italian Matrix Test), auditory working memory tasks, and patient-reported outcome measures to evaluate listening effort and quality of life.
It is anticipated that participants receiving active rTMS will exhibit enhanced phase-locking and neural synchrony, particularly in encoding the fundamental frequency (F0) and formant trajectories of speech sounds. These changes would reflect a positive modulation of auditory brainstem and cortical responses, supporting the hypothesis that rTMS can facilitate auditory neural plasticity in CI users.
This study aims to provide preliminary evidence supporting the use of repetitive transcranial magnetic stimulation (rTMS) as a modulatory tool for early-stage neural speech encoding in cochlear implant users. By investigating its effects on the Frequency-Following Response (FFR), the research intends to contribute to the development of an integrated and innovative approach to auditory rehabilitation, potentially enhancing speech perception outcomes in individuals with limited cochlear implant experience.
Dr. Angelo Immordino is a medical doctor specialized in Otorhinolaryngology and holds a Ph.D. in Biomedicine and Neuroscience from the University of Palermo, Italy. He currently serves as Consultant ENT Surgeon at the University Hospital “Paolo Giaccone” in Palermo and is a Contract Professor in Rhinologic Emergencies at the School of Specialization in Otorhinolaryngology of the University of Palermo.
His clinical and surgical practice focuses on otologic and audiologic disorders, including cochlear implantation, middle ear surgery, and vertigo. He has gained international experience through a fellowship in Audiology and Vestibology at Maastricht University Medical Centre+ (The Netherlands),
Dr. Immordino has authored and co-authored numerous publications in indexed journals and international volumes
His Ph.D. research focused on the relationship between cochlear implant electrode positioning and its impact on electrophysiological markers and hearing outcomes.
Dr. Immordino has been an invited speaker and faculty member at numerous national and international conferences and surgical cadaver labs. He has also participated in the scientific and organizing committees of ENT events and served as thesis advisor for several medical and ENT specialization students.
He is an active member of: the Italian Society of Otorhinolaryngology and Cervico-Facial Surgery (SIOeChCF), the Young Otolaryngologists of the International Federation of Oto-Rhino-Laryngological Societies (YO-IFOS), the GOS-Sicilia board.
Samet Kılıç is an Assistant Professor in the Department of Audiology at Trakya University. He holds a PhD (2022) and a Master’s degree (2018) in Audiology and Speech Pathology from Hacettepe University. His doctoral research focused on objective methods for assessing listening effort from a neural perspective.
In addition to his clinical expertise, Dr. Kılıç has a diverse educational background, holding degrees in Sociology (2020) and History (2023), and a bachelor's degree in Physiotherapy and Rehabilitation (2011).
Professional Experience
Academic Roles: Before his current position at Trakya University, he served as a Research Assistant at Hacettepe University for eight years.
International Experience: He conducted research at Ghent University in Belgium as part of the Erasmus+ program in 2016
Service: He serves as an Assistant Editor for the Balkan Journal of Health Sciences and is actively involved in organizing international audiology congresses.
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