Central Auditory Encoding in Cochlear Implant Users
09-12, 10:45–11:45 (Europe/Istanbul), Audiology 2

<p>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.</p> <p>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.</p> <p>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.</p> <p>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.</p>

<p>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.</p>
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<p>I completed my graduate training in Audiology and Speech and Language Disorders at Istanbul University-Cerrahpaşa, where I obtained both my Master’s and PhD degrees. I continue to pursue academic and clinical work in the field of hearing sciences.</p> <p>My primary areas of expertise include cochlear implant applications, preoperative candidate assessment, intraoperative monitoring, postoperative audiological follow-up, and long-term outcome evaluation. My work also encompasses advanced electrophysiological assessments, including auditory brainstem response (ABR), electrically evoked auditory brainstem response (eABR), and electrically evoked cortical auditory evoked potentials (eCAEP). I further focus on integrating comprehensive objective test batteries into evidence-based clinical decision-making processes.</p> <p>My research addresses the diagnosis of hearing loss in both pediatric and adult populations, as well as the systematic evaluation of preoperative, intraoperative, and postoperative cochlear implant processes and outcomes. I have presented scientific papers at national and international conferences and continue to integrate research activities with clinical practice.</p>
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<p>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.</p> <p>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).</p> <p>Professional Experience</p> <p>- Academic Roles: Before his current position at Trakya University, he served as a Research Assistant at Hacettepe University for eight years.<br>- International Experience: He conducted research at Ghent University in Belgium as part of the Erasmus+ program in 2016<br>- Service: He serves as an Assistant Editor for the Balkan Journal of Health Sciences and is actively involved in organizing international audiology congresses.</p>
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<p>Training as Electrical Engineer, PhD thesis on electrical stimulation of the auditory nerve at the Institute of Biomedical Engineering at the ETH and University of Zurich.</p> <p>Lecturer (1996) and Professor of Experimental Audiology (2002) at the University of Zurich, head of the Laboratory of Experimental Audiology at the ENT Department since 1978.</p> <p>Past president of the German Society of Audiology and former board member of the European Federation of Audiology Societies (EFAS).</p> <p>Main research interests: better understand and improve the function of auditory prostheses such as cochlear implants, auditory brainstem implants as well as conventional and implantable hearing aids. Enhance the speech discrimination performance, especially in noisy environments and improve the sound quality for music perception with these devices. Investigate new methods for programming and speech processor fitting using objective electrophysiological measurement procedures.</p>
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<p>CI -ABI And electrophysiology. CI -ABI And electrophysiology. CI -ABI And electrophysiology</p> <p>I received my MSc and phd degrees in audiology from Hacettepe University, where I am currently affiliated in department of audiology. My research interests are implantable devices (cochlear implants, auditory brainstem implants, bone anchored hearing aids), auditory cortical evoked potentials and auditory perception.</p>
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