Evaluation of an interactive music awareness program for cochlear implant recipients

The objective of this study was to evaluate the efficacy of a prototype interactive music awareness program (IMAP) for adult cochlear implant (CI) users. An unblinded, randomized, crossover design was used. Twenty-one CI users were recruited and allocated to two groups. Group 1 received the IMAP first, followed by a retention of learning phase. Group 2 were given the IMAP after 12 weeks. Participants were instructed to undertake two half-hour sessions per week at home over 12 weeks. Both groups attended appointments at the start, halfway through, and at the end of the trial. At each appointment participants completed tests of speech perception, melodic contour identification and instrument recognition, rated the sound quality of music, and indicated their music listening habits. Sixteen participants completed the study. Following training both groups showed improved instrument recognition abilities and feedback suggests further positive impact on participants’ lives. The findings suggest that the IMAP is beneficial for music perception and in particular, improved instrument recognition

La percezione e la riabilitazione musicale nei portatori di impianto cocleare: risultati di uno studio osservazionale seguito da un trial clinico

Background. L’impianto cocleare (IC) fornisce degli ottimi risultati per la percezione verbale, mentre l’ascolto della musica è limitato. Sono stati sviluppati trattamenti riabilitativi musicali dedicati, che ad oggi risultano scarsamente applicati in ambito clinico, anche per la mancanza di indicatori adeguati. Infine, non vi è chiarezza sugli effetti cross-dominio del training musicale, in particolare per quanto riguarda l’ascolto nel rumore e la produzione vocale. Scopo della tesi. La presente tesi è composta da due fasi sperimentali. L’obiettivo della prima fase è la valutazione delle caratteristiche epidemiologiche, cliniche e l’identificazione dell’eventuale presenza di esigenze riabilitative nel campione. La seconda fase del trial clinico valuterà gli effetti di un intervento riabilitativo autosomministrato a domicilio sulla percezione soggettiva della musica, la percezione uditiva in ambiente rumoroso e la produzione vocale. Materiali e metodi. I partecipanti allo studio osservazionale sono stati sottoposti a visita audiologica e foniatrica, audiometria tonale e vocale, valutazione PCVRAR e hanno compilato i questionari I-NCIQ e MUSQUAV. I pazienti coinvolti nel trial clinico, arruolati tra i partecipanti dello studio osservazionale, sono stati sottoposti a valutazioni ulteriori, comprendenti MATRIX test, videolaringoscopia e analisi spettroacustica vocale. A questi ultimi è stato fornito l’accesso a Meludia, un’applicazione web che permette di apprendere i fondamenti della musica, secondo un programma individuale. L’intervento ha avuto una durata di un mese, alla fine del quale i pazienti sono stati sottoposti ad una seconda valutazione per il raffronto dei risultati. Sono stati utilizzati i test statistici di Pearson, ANOVA e ANCOVA e valori p<0,05 sono stati considerati significativi. Risultati. Nei 79 pazienti che hanno preso parte alla prima fase osservazionale, la soglia uditiva media PTA2 all’audiometria tonale è 29,7 ±5,7 dB e la SRT media risulta di 40,0 ±9,3 dB. L’I-NCIQ mostra un punteggio medio di 64,6 ±13,1. L’esigenza riabilitativa (Fattore Rehab) è presente in 50 pazienti (63,3%). Si osserva una correlazione negativa significativa con test di Pearson tra età e Frequenza MUSQUAV (r=­0,385, p-value<.001), non ci sono differenze significative per l’epoca di esordio (test ANCOVA p=0,089). Il training musicale è stato portato a termine da 12 su 15 pazienti, con un trend di miglioramento individuale più evidente in metà del campione. Il test ANOVA non ha segnalato differenze statisticamente significative prima e dopo il trattamento. Conclusioni. Lo studio osservazionale ha mostrato la presenza di buoni outcome audiologici. Sebbene si evidenzi una spiccata variabilità interindividuale, la qualità di vita è soddisfacente e i dati sono in linea con quanto riportato in letteratura. È stato rilevato che l’aumento dell’età è associato ad una riduzione delle competenze percettive musicali, mentre l’epoca di esordio dell’ipoacusia non incide in maniera significativa. Si è proposto un nuovo strumento per la valutazione delle esigenze riabilitative, il Fattore Rehab, secondo il quale un percorso di riabilitazione uditiva musicale è indicato per il 63% dei soggetti considerati. Il training musicale da remoto autocondotto (App Meludia) si è confermata come una valida possibilità riabilitativa, con un miglioramento individuale in Percezione o Coinvolgimento musicale nel 50% dei pazienti dopo un solo mese di trattamento. Non vi sono evidenze significative di effetti cross-dominio, né per la percezione verbale, né per la produzione vocale. L’ampliamento del campione e ulteriori studi clinici randomizzati multicentrici saranno necessari per confermare i risultati preliminari della presente tesi.Background. Cochlear implant (CI) provides excellent results for verbal perception, while listening to music is limited. Dedicated musical rehabilitation treatments have been developed, which to date are poorly applied in the clinical setting, also due to the lack of adequate indicators. Finally, some evidence suggested a cross-domain effects of music training, in particular about listening in noise and vocal production. Objectives. The present work encompassed two phases. The objective of the first phase is the evaluation of the epidemiological and clinical feature of the study group and the identification of the possible presence of rehabilitation needs in the sample. The second phase of the clinical trial will evaluate the effects of a self-administered rehabilitation intervention at home on the subjective perception of music, auditory perception in a noisy environment and speech production. Material and methods. Participants in the observational study underwent audiological and phoniatric examination, pure tone and speech audiometry, PCVRAR assessment and filled the I-NCIQ and MUSQUAV questionnaires. The patients involved in the clinical trial, enrolled among the participants of the observational study, underwent further evaluations, including MATRIX test, video laryngoscopy and voice spectroacoustic analysis. The latter patients were given access to Meludia, a web application that allows to learn the fundamentals of music, following an individual program. The surgery lasted one month, at the end of which the patients underwent a second evaluation to compare the results. Pearson's statistical tests, ANOVA and ANCOVA were used and p-values <0.05 were considered significant. Results. 79 patients took part in the first observational phase. Average PTA2 hearing threshold at pure tone audiometry was 29.7 ± 5.7 dB and average SRT was 40.0 ± 9.3 dB. The I-NCIQ showed an average score of 64.6 ± 13.1. The rehabilitation need (Rehab Factor) was present in 50 patients (63.3%). There was a significant negative correlation with Pearson's test between age and MUSQUAV frequency (r = 0.385, p-value <.001), there were no significant differences for hearing loss onset (ANCOVA test p =0.089). Music training was completed by 12 out of 15 patients, with an individual improvement trend more evident in half of the sample. The ANOVA test did not report statistically significant differences before and after treatment. Conclusion. The observational study retrieved adequate audiological outcomes. Although there was a marked inter-individual variability, the quality of life was satisfactory and the data were in line with what was reported in the literature. It was found that increasing age is associated with a reduction in musical perceptual skills, while the time of onset of hearing loss does not have a significant impact. A new tool has been proposed for the assessment of rehabilitation needs, the Rehab factor, according to which a musical auditory rehabilitation course is indicated for 63% of the patients. The self-conducted remote music training (App Meludia) has been confirmed as a valid rehabilitation possibility, with an individual improvement in musical Perception or Engagement in 50% of patients after just one month of treatment. There was no significant evidence of cross-domain effects, neither for verbal perception in noise nor for speech production. The enrollment of further patients as well as multicenter randomized clinical trials would be necessary to confirm the preliminary results of this thesis work

Music and the transhuman ear: Ultrasonics, material bodies, and the limits of sensation

Amid recent moves toward sound as vibrational force, this article argues that hearing has a special role in determining our natural sensory limits, and that recent attempts to push against these limits foreground the underlying matter of what status the biological body has in music perception and performance during the technological age. Between 1876 and 1894, prominent German acousticians—including Helmholtz—argued that humans could hear vibrations as high as 40,960Hz. While this was ultimately discredited, recent post-tonal works have notated pitches that explicitly play with, or exceed, the ordinary range of human hearing; (cf. Schoenberg, Per Nørgård, and Salvatore Sciarrino). In the context of existing ecological approaches to listening, this article asks what kind of listener such works imply. Specifically, it investigates the musical relevance of Umwelt theory by the Baltic German biologist Jakob von Uexküll, in which individuals “create” the bubble of their perceivable environment according to a reciprocal interchange between limited sense capacity and mental habit. I contrast Uexküll’s acceptance of human limits with a transhumanist worldview which anticipates the enhancement of biological sense capacities through technology. Such “morphological freedom - the right to modify and enhance one’s body” (Bostrum 2009) putatively includes augmentation of the auditory system. Finally, by tracing the genealogy of human prosthesis back to the founder of a philosopher of technology (Kapp 1877), I critique the potential for technologies in clinical audiology to grant access to ultrasonic frequencies, and assess the implications of augmented, prosthetic hearing for non-impaired listeners. The discourse of transhumanism poses questions for musical listening as soon as the body becomes an assemblage subject to variation. It raises the question of how identity—ours as well as that of musical works—might be affected by “morphological freedom,” the extent to which self-identity becomes the lost referential when agency is distributed between biological and non-biological parts, and it asks what value are the new intellectual vistas that emerge when musical experience is conceived in material terms as communication between bodies

Music and the Transhuman Ear: Ultrasonics, Material Bodies, and the Limits of Sensation

Amid recent moves toward sound as vibrational force, this article argues that hearing has a special role in determining our natural sensory limits, and that recent attempts to push against these limits foreground the underlying matter of what status the biological body has in music perception and performance during the technological age. Between 1876 and 1894, prominent German acousticians—including Helmholtz—argued that humans could hear vibrations as high as 40,960Hz. While this was ultimately discredited, recent post-tonal works have notated pitches that explicitly play with, or exceed, the ordinary range of human hearing; (cf. Schoenberg, Per Nørgård, and Salvatore Sciarrino). In the context of existing ecological approaches to listening, this article asks what kind of listener such works imply. Specifically, it investigates the musical relevance of Umwelt theory by the Baltic German biologist Jakob von Uexküll, in which individuals “create” the bubble of their perceivable environment according to a reciprocal interchange between limited sense capacity and mental habit. I contrast Uexküll’s acceptance of human limits with a transhumanist worldview which anticipates the enhancement of biological sense capacities through technology. Such “morphological freedom - the right to modify and enhance one’s body” (Bostrum 2009) putatively includes augmentation of the auditory system. Finally, by tracing the genealogy of human prosthesis back to the founder of a philosopher of technology (Kapp 1877), I critique the potential for technologies in clinical audiology to grant access to ultrasonic frequencies, and assess the implications of augmented, prosthetic hearing for non-impaired listeners. The discourse of transhumanism poses questions for musical listening as soon as the body becomes an assemblage subject to variation. It raises the question of how identity—ours as well as that of musical works—might be affected by “morphological freedom,” the extent to which self-identity becomes the lost referential when agency is distributed between biological and non-biological parts, and it asks what value are the new intellectual vistas that emerge when musical experience is conceived in material terms as communication between bodies

Error Signals from the Brain: 7th Mismatch Negativity Conference

The 7th Mismatch Negativity Conference presents the state of the art in methods, theory, and application (basic and clinical research) of the MMN (and related error signals of the brain). Moreover, there will be two pre-conference workshops: one on the design of MMN studies and the analysis and interpretation of MMN data, and one on the visual MMN (with 20 presentations). There will be more than 40 presentations on hot topics of MMN grouped into thirteen symposia, and about 130 poster presentations. Keynote lectures by Kimmo Alho, Angela D. Friederici, and Israel Nelken will round off the program by covering topics related to and beyond MMN

The ‘Interactive Music Awareness Program’ (IMAP) for cochlear implant users

There is some evidence that structured training can benefit cochlear implant (CI) users' appraisal of music as well as their music perception abilities. There are currently very limited music training resources available for CI users to explore. This demonstration will introduce delegates to the `Interactive Music Awareness Program' (IMAP) for cochlear implant users, which was developed in response to the need for a client-centered, structured, interactive, creative, open-ended, educational and challenging music (re)habilitation resource

Reports to the President

A compilation of annual reports for the 1999-2000 academic year, including a report from the President of the Massachusetts Institute of Technology, as well as reports from the academic and administrative units of the Institute. The reports outline the year's goals, accomplishments, honors and awards, and future plans

Participatory design of a music aural rehabilitation programme

Objectives: Many cochlear implant (CI) users wish to enjoy music but are dissatisfied by its quality as perceived through their implant. Although there is evidence to suggest that training can improve CI users’ perception and appraisal of music, availability of interactive music-based aural rehabilitation for adults is limited. In response to this need, an ‘Interactive Music Awareness Programme’ (IMAP) was developed with and for adult CI users.Methods: An iterative design and evaluation approach was used. The process began with identification of user needs through consultations, followed by use of mock-up applications in workshops. Feedback from these were used to develop the prototype IMAP; a program of 24 interactive sessions, enabling users to create and manipulate music. The prototype IMAP was subsequently evaluated in a home trial with 16 adult CI users over a period of 12 weeks. Results: Overall ratings for the prototype IMAP were positive and indicated that it met users' needs. Quantitative and qualitative feedback on the sessions and software in the prototype IMAP were used to identify aspects of the programme that worked well and aspects that required improvement. The IMAP was further developed in response to users' feedback and is freely available online.Conclusions: The participatory design approach used in developing the IMAP was fundamental in ensuring its relevance, and regular feedback from end users in each phase of development proved valuable for early identification of issues. Observations and feedback from end users supported a holistic approach to music aural rehabilitation. <br/