A new method of auditory training through the addition of attentional neuromodulation techniques: A pilot study
Abstract
Background and Aim: Effective communication relies on understanding speech in noise, which can be challenging, especially for hearing-impaired children. Auditory attention influences speech perception in noise, and Auditory attention training can help improve this critical auditory skill. Today's neuromodulation methods are used in rehabilitation. Transcranial-direct-current-stimulation(tDCS) is a promising approach among these methods. Our hypothesis is that combining electrical stimulation with behavioral auditory training could accelerate and enhance the effectiveness of auditory training, improving speech comprehension in noise.
Methods: A pilot study was conducted on 8 children with moderate to severe hearing loss. In this study, tDCS was administered to the right and left dorsolateral prefrontal cortex in addition to behavioral auditory attention training. The participants were divided into two groups, one receiving real stimulation and the other receiving sham stimulation. 20 minutes of intervention were conducted through ten sessions. The test-of-everyday-attention-for-children (TEA-CH) and the monaural-selective-auditory-attention-test (mSAAT) tests were used as behavioral assessments, and the auditory P300 were recorded as an electrophysiological test to measure attention. Also, speech-in-noise tests were utilized. All tests were conducted before, immediately, and one month after training.
Results: Children in both groups demonstrated noticeable progress in all tests following the training sessions. There was a significant difference in the level of improvement in mSAAT, TEA-CH, word-in-noise, and P300 latency between the two groups. Improvement was more remarkable in children receiving real stimulation.
Conclusion: When behavioral attention training is combined with attention neuromodulation through tDCS, it may enhance rehabilitation effectiveness and increase the stability of tDCS effects.
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10. Lema A, Carvalho S, Fregni F, Gonçalves ÓF, Leite J. The effects of direct current stimulation and random noise stimulation on attention networks. Sci Rep. 2021;11(1):6201. [DOI:10.1038/s41598-021-85749-7]
11. Moslemi B, Azmodeh M, Tabatabaei SM, Alivandi Vafa M. [The effectiveness of transcranial direct current stimulation (tDCS) on attention and visual-auditory working memory in children with dyslexia]. Journal of Exceptional Children. 2021;20(4):93-104. Persian.
12. Sprengel R. Role of AMPA receptors in synaptic plasticity. Cell Tissue Res. 2006;326(2):447-55. [DOI:10.1007/s00441-006-0275-4]
13. Frase L, Mertens L, Krahl A, Bhatia K, Feige B, Heinrich SP, et al. Transcranial direct current stimulation induces long-term potentiation-like plasticity in the human visual cortex. Transl Psychiatry. 2021;11(1):17. [DOI:10.1038/s41398-020-01134-4]
14. Mattioli F, Bellomi F, Stampatori C, Capra R, Miniussi C. Neuroenhancement through cognitive training and anodal tDCS in multiple sclerosis. Mult Scler. 2016;22(2):222-30. [DOI:10.1177/1352458515587597]
15. Petit L, Simon G, Joliot M, Andersson F, Bertin T, Zago L, et al. Right hemisphere dominance for auditory attention and its modulation by eye position: an event related fMRI study. Restor Neurol Neurosci. 2007;25(3-4):211-25.
16. Miler JA, Meron D, Baldwin DS, Garner M. The Effect of Prefrontal Transcranial Direct Current Stimulation on Attention Network Function in Healthy Volunteers. Neuromodulation. 2018;21(4):355-361. [DOI:10.1111/ner.12629]
17. Kuo MF, Polanía R, Nitsche M. Physiology of Transcranial Direct and Alternating Current Stimulation. In: Brunoni A, Nitsche M, Loo C, editors. Transcranial Direct Current Stimulation in Neuropsychiatric Disorders: Clinical Principles and Management. 1st ed. Cham: Springer International Publishing; 2016. p. 29-46.
18. Fathi N, Hassani Mehraban A, Akbarfahimi M, Mirzaie H. Validity and Reliability of the Test of Everyday Attention for Children (TEACh) in Iranian 8-11 Year Old Normal Students. Iran J Psychiatry Behav Sci. 2017;11(1):e2854. [DOI:10.5812/ijpbs.2854]
19. Aarabi S, Jarollahi F, Jalaie S. Development and determination of the validity of Persian version of monaural selective auditory attention test in learning disabled children. Aud Vestib Res. 2016;25(1):49-54.
20. Chupani J, Javanbakht M, Lotfi Y. Central auditory processing in bilinguals. Aud Vestib Res. 2021;30(3):160-6. [DOI:10.18502/avr.v30i3.6529]
21. Lotfi Y, Kargar S, Javanbakht M, Biglarian A. Development, Validity and Reliability of the Persian Version of the Consonant-Vowel in White Noise Test. JRSR. 2016;3(2):29-34. [DOI:10.30476/jrsr.2016.41090]
22. Lotfi Y, Salim S, Mehrkian S, Ahmadi T, Biglarian A. The Persian version of words-in-noise test for young population: development and validation. Aud Vestib Res. 2016;25(4):194-200.
23. Moossavi A, Mehrkian S, Karami F, Biglarian A, Mahmoodi Bakhtiari B. Developing of Persian version of the BKB sentences and content validity assessment. Aud Vestib Res. 2017;26(1):27-33.
24. Kim M, Lee TH, Hwang WJ, Lee TY, Kwon JS. Auditory P300 as a Neurophysiological Correlate of Symptomatic Improvement by Transcranial Direct Current Stimulation in Patients With Schizophrenia: A Pilot Study. Clin EEG Neurosci. 2020;51(4):252-8. [DOI:10.1177/1550059418815228]
25. Reis AC, Frizzo AC, Isaac Mde L, Garcia CF, Funayama CA, Iório MC. P300 in individuals with sensorineural hearing loss. Braz J Otorhinolaryngol. 2015;81(2):126-32. [DOI:10.1016/j.bjorl.2014.10.001]
26. Bell L, Scharke W, Reindl V, Fels J, Neuschaefer-Rube C, Konrad K. Auditory and Visual Response Inhibition in Children with Bilateral Hearing Aids and Children with ADHD. Brain Sci. 2020;10(5):307. [DOI:10.3390/brainsci10050307]
27. Martin DM, Liu R, Alonzo A, Green M, Loo CK. Use of transcranial direct current stimulation (tDCS) to enhance cognitive training: effect of timing of stimulation. Exp Brain Res. 2014;232(10):3345-51. [DOI:10.1007/s00221-014-4022-x]
28. Nitsche MA, Paulus W. Excitability changes induced in the human motor cortex by weak transcranial direct current stimulation. J Physiol. 2000 Sep 15;527 Pt 3(Pt 3):633-9. [DOI:10.1111/j.1469-7793.2000.t01-1-00633.x]
29. Martin DM, Liu R, Alonzo A, Green M, Player MJ, Sachdev P, et al. Can transcranial direct current stimulation enhance outcomes from cognitive training? A randomized controlled trial in healthy participants. Int J Neuropsychopharmacol. 2013;16(9):1927-36. [DOI:10.1017/S1461145713000539]
30. Boroda E, Krueger AM, Bansal P, Schumacher MJ, Roy AV, Boys CJ, et al. A randomized controlled trial of transcranial direct-current stimulation and cognitive training in children with fetal alcohol spectrum disorder. Brain Stimul. 2020;13(4):1059-68.
31. Alvarez-Alvarado S, Boutzoukas EM, Kraft JN, O'Shea A, Indahlastari A, Albizu A, et al. Impact of Transcranial Direct Current Stimulation and Cognitive Training on Frontal Lobe Neurotransmitter Concentrations. Front Aging Neurosci. 2021;13:761348. [DOI:10.3389/fnagi.2021.761348]
32. Martin DM, Mohan A, Alonzo A, Gates N, Gbadeyan O, Meinzer M, et al. A Pilot Double-Blind Randomized Controlled Trial of Cognitive Training Combined with Transcranial Direct Current Stimulation for Amnestic Mild Cognitive Impairment. J Alzheimers Dis. 2019;71(2):503-12. [DOI:10.3233/JAD-190306]
33. Soveri A, Tallus J, Laine M, Nyberg L, Bäckman L, Hugdahl K, et al. Modulation of auditory attention by training: evidence from dichotic listening. Exp Psychol. 2013;60(1):44-52. [DOI:10.1027/1618-3169/a000172]
34. Hwang JS, Kim KH, Lee JH. Factors Affecting Sentence-in-Noise Recognition for Normal Hearing Listeners and Listeners with Hearing Loss. J Audiol Otol. 2017;21(2):81-7. [DOI:10.7874/jao.2017.21.2.81]
35. Murugaraja V, Shivakumar V, Sivakumar PT, Sinha P, Venkatasubramanian G. Clinical utility and tolerability of transcranial direct current stimulation in mild cognitive impairment. Asian J Psychiatr. 2017;30:135-40. [DOI:10.1016/j.ajp.2017.09.001]
36. Yadollahpour A, Rashidi S, Saki N, Kunwar PS, Mayo-Yáñez M. Repeated Bilateral Transcranial Direct Current Stimulation over Auditory Cortex for Tinnitus Treatment: A Double-Blinded Randomized Controlled Clinical Trial. Brain Sci. 2024;14(4):373. [DOI:10.3390/brainsci14040373]
37. Watanabe Y, Dezawa S, Takei H, Nagasaka K, Takashima I. Hippocampal-prefrontal long-term potentiation-like plasticity with transcranial direct current stimulation in rats. Neurobiol Learn Mem. 2023;201:107750. [DOI:10.1016/j.nlm.2023.107750]
2. Kral A. Hearing and Cognition in Childhood. Laryngorhinootologie. 2023;102(S 01):S3-11. [DOI:10.1055/a-1973-5087]
3. Simon M, Campbell E, Lepore F. Cross-modal plasticity and central deficiencies: the case of deafness and the use of cochlear implants. Handb Clin Neurol. 2020;174:343-55. [DOI:10.1016/B978-0-444-64148-9.00025-9]
4. Aslan F, Ertugrul G, Sennaroglu G, Sennaroglu L. Unimodal versus bimodal auditory stimulation in inner ear malformations: Cognitive, language, and motor performance. Laryngoscope Investig Otolaryngol. 2023;8(5):1401-9. [DOI:10.1002/lio2.1153]
5. Yin Y, Lyu X, Zhou J, Yu K, Huang M, Shen G, et al. Cerebral cortex functional reorganization in preschool children with congenital sensorineural hearing loss: a resting-state fMRI study. Front Neurol. 2024;15:1423956. [DOI:10.3389/fneur.2024.1423956]
6. Saccone EJ, Tian M, Bedny M. Developing cortex is functionally pluripotent: Evidence from blindness. Dev Cogn Neurosci. 2024;66:101360. [DOI:10.1016/j.dcn.2024.101360]
7. Gohari N, Dastgerdi ZH, Rouhbakhsh N, Afshar S, Mobini R. Training Programs for Improving Speech Perception in Noise: A Review. J Audiol Otol. 2023;27(1):1-9. [DOI:10.7874/jao.2022.00283]
8. Rahimi V, Mohammadkhani G, Alaghband Rad J, Mousavi SZ, Khalili ME. Modulation of auditory temporal processing, speech in noise perception, auditory-verbal memory, and reading efficiency by anodal tDCS in children with dyslexia. Neuropsychologia. 2022;177:108427. [DOI:10.1016/j.neuropsychologia.2022.108427]
9. Rooholamini S, Soleymani M, Vaghef L. [Effectiveness of Transcranial Direct Current Stimulation (TDCS) onExecutive Functions(selective attention and flexibility) in Students with Dyslexia]. Journal of Learning Disabilities. 2018;8(1):23-41. Persian. [DOI:10.22098/JLD.2018.707]
10. Lema A, Carvalho S, Fregni F, Gonçalves ÓF, Leite J. The effects of direct current stimulation and random noise stimulation on attention networks. Sci Rep. 2021;11(1):6201. [DOI:10.1038/s41598-021-85749-7]
11. Moslemi B, Azmodeh M, Tabatabaei SM, Alivandi Vafa M. [The effectiveness of transcranial direct current stimulation (tDCS) on attention and visual-auditory working memory in children with dyslexia]. Journal of Exceptional Children. 2021;20(4):93-104. Persian.
12. Sprengel R. Role of AMPA receptors in synaptic plasticity. Cell Tissue Res. 2006;326(2):447-55. [DOI:10.1007/s00441-006-0275-4]
13. Frase L, Mertens L, Krahl A, Bhatia K, Feige B, Heinrich SP, et al. Transcranial direct current stimulation induces long-term potentiation-like plasticity in the human visual cortex. Transl Psychiatry. 2021;11(1):17. [DOI:10.1038/s41398-020-01134-4]
14. Mattioli F, Bellomi F, Stampatori C, Capra R, Miniussi C. Neuroenhancement through cognitive training and anodal tDCS in multiple sclerosis. Mult Scler. 2016;22(2):222-30. [DOI:10.1177/1352458515587597]
15. Petit L, Simon G, Joliot M, Andersson F, Bertin T, Zago L, et al. Right hemisphere dominance for auditory attention and its modulation by eye position: an event related fMRI study. Restor Neurol Neurosci. 2007;25(3-4):211-25.
16. Miler JA, Meron D, Baldwin DS, Garner M. The Effect of Prefrontal Transcranial Direct Current Stimulation on Attention Network Function in Healthy Volunteers. Neuromodulation. 2018;21(4):355-361. [DOI:10.1111/ner.12629]
17. Kuo MF, Polanía R, Nitsche M. Physiology of Transcranial Direct and Alternating Current Stimulation. In: Brunoni A, Nitsche M, Loo C, editors. Transcranial Direct Current Stimulation in Neuropsychiatric Disorders: Clinical Principles and Management. 1st ed. Cham: Springer International Publishing; 2016. p. 29-46.
18. Fathi N, Hassani Mehraban A, Akbarfahimi M, Mirzaie H. Validity and Reliability of the Test of Everyday Attention for Children (TEACh) in Iranian 8-11 Year Old Normal Students. Iran J Psychiatry Behav Sci. 2017;11(1):e2854. [DOI:10.5812/ijpbs.2854]
19. Aarabi S, Jarollahi F, Jalaie S. Development and determination of the validity of Persian version of monaural selective auditory attention test in learning disabled children. Aud Vestib Res. 2016;25(1):49-54.
20. Chupani J, Javanbakht M, Lotfi Y. Central auditory processing in bilinguals. Aud Vestib Res. 2021;30(3):160-6. [DOI:10.18502/avr.v30i3.6529]
21. Lotfi Y, Kargar S, Javanbakht M, Biglarian A. Development, Validity and Reliability of the Persian Version of the Consonant-Vowel in White Noise Test. JRSR. 2016;3(2):29-34. [DOI:10.30476/jrsr.2016.41090]
22. Lotfi Y, Salim S, Mehrkian S, Ahmadi T, Biglarian A. The Persian version of words-in-noise test for young population: development and validation. Aud Vestib Res. 2016;25(4):194-200.
23. Moossavi A, Mehrkian S, Karami F, Biglarian A, Mahmoodi Bakhtiari B. Developing of Persian version of the BKB sentences and content validity assessment. Aud Vestib Res. 2017;26(1):27-33.
24. Kim M, Lee TH, Hwang WJ, Lee TY, Kwon JS. Auditory P300 as a Neurophysiological Correlate of Symptomatic Improvement by Transcranial Direct Current Stimulation in Patients With Schizophrenia: A Pilot Study. Clin EEG Neurosci. 2020;51(4):252-8. [DOI:10.1177/1550059418815228]
25. Reis AC, Frizzo AC, Isaac Mde L, Garcia CF, Funayama CA, Iório MC. P300 in individuals with sensorineural hearing loss. Braz J Otorhinolaryngol. 2015;81(2):126-32. [DOI:10.1016/j.bjorl.2014.10.001]
26. Bell L, Scharke W, Reindl V, Fels J, Neuschaefer-Rube C, Konrad K. Auditory and Visual Response Inhibition in Children with Bilateral Hearing Aids and Children with ADHD. Brain Sci. 2020;10(5):307. [DOI:10.3390/brainsci10050307]
27. Martin DM, Liu R, Alonzo A, Green M, Loo CK. Use of transcranial direct current stimulation (tDCS) to enhance cognitive training: effect of timing of stimulation. Exp Brain Res. 2014;232(10):3345-51. [DOI:10.1007/s00221-014-4022-x]
28. Nitsche MA, Paulus W. Excitability changes induced in the human motor cortex by weak transcranial direct current stimulation. J Physiol. 2000 Sep 15;527 Pt 3(Pt 3):633-9. [DOI:10.1111/j.1469-7793.2000.t01-1-00633.x]
29. Martin DM, Liu R, Alonzo A, Green M, Player MJ, Sachdev P, et al. Can transcranial direct current stimulation enhance outcomes from cognitive training? A randomized controlled trial in healthy participants. Int J Neuropsychopharmacol. 2013;16(9):1927-36. [DOI:10.1017/S1461145713000539]
30. Boroda E, Krueger AM, Bansal P, Schumacher MJ, Roy AV, Boys CJ, et al. A randomized controlled trial of transcranial direct-current stimulation and cognitive training in children with fetal alcohol spectrum disorder. Brain Stimul. 2020;13(4):1059-68.
31. Alvarez-Alvarado S, Boutzoukas EM, Kraft JN, O'Shea A, Indahlastari A, Albizu A, et al. Impact of Transcranial Direct Current Stimulation and Cognitive Training on Frontal Lobe Neurotransmitter Concentrations. Front Aging Neurosci. 2021;13:761348. [DOI:10.3389/fnagi.2021.761348]
32. Martin DM, Mohan A, Alonzo A, Gates N, Gbadeyan O, Meinzer M, et al. A Pilot Double-Blind Randomized Controlled Trial of Cognitive Training Combined with Transcranial Direct Current Stimulation for Amnestic Mild Cognitive Impairment. J Alzheimers Dis. 2019;71(2):503-12. [DOI:10.3233/JAD-190306]
33. Soveri A, Tallus J, Laine M, Nyberg L, Bäckman L, Hugdahl K, et al. Modulation of auditory attention by training: evidence from dichotic listening. Exp Psychol. 2013;60(1):44-52. [DOI:10.1027/1618-3169/a000172]
34. Hwang JS, Kim KH, Lee JH. Factors Affecting Sentence-in-Noise Recognition for Normal Hearing Listeners and Listeners with Hearing Loss. J Audiol Otol. 2017;21(2):81-7. [DOI:10.7874/jao.2017.21.2.81]
35. Murugaraja V, Shivakumar V, Sivakumar PT, Sinha P, Venkatasubramanian G. Clinical utility and tolerability of transcranial direct current stimulation in mild cognitive impairment. Asian J Psychiatr. 2017;30:135-40. [DOI:10.1016/j.ajp.2017.09.001]
36. Yadollahpour A, Rashidi S, Saki N, Kunwar PS, Mayo-Yáñez M. Repeated Bilateral Transcranial Direct Current Stimulation over Auditory Cortex for Tinnitus Treatment: A Double-Blinded Randomized Controlled Clinical Trial. Brain Sci. 2024;14(4):373. [DOI:10.3390/brainsci14040373]
37. Watanabe Y, Dezawa S, Takei H, Nagasaka K, Takashima I. Hippocampal-prefrontal long-term potentiation-like plasticity with transcranial direct current stimulation in rats. Neurobiol Learn Mem. 2023;201:107750. [DOI:10.1016/j.nlm.2023.107750]
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How to Cite
1.
Mansouri N, Shaabani M, Jahan A, Bakhshi E, Javanbakht M. A new method of auditory training through the addition of attentional neuromodulation techniques: A pilot study. Aud Vestib Res. 2025;.
