Pharmacological enhancement of aural habilitation in adult cochlear implant users.
OBJECTIVE
The purpose of this report was to examine the preliminary data collected under a larger on-going feasibility study conducted with cochlear implant patients exploring the potential benefit of pharmacologically-enhanced aural rehabilitation therapy as a means of increasing speech tracking skills.


METHODS
Eight adult cochlear implant participants participated in a randomized, double-blind study and received either 10 mg d-amphetamine (Treatment group, N = 4) or a placebo (Placebo group, N = 4) 60 minutes prior to a 1.5 hour intensive aural rehabilitation session occurring twice a week for two months. Treatment consisted of a multi-step rehabilitation program individualized for each participant to develop auditory-only speech tracking skills. Prior to and at the conclusion of the therapy sessions, SPECT rCBF imaging and speech tracking assessments were conducted.


RESULTS
Speech tracking scores of the placebo and treatment groups were similar before the aural habilitation intervention. In the placebo group, speech tracking performance increased 13.5% for visual plus auditory and auditory only presentations as a function of aural habilitation alone. The 10 mg d-amphetamine-facilitated program resulted in minimal increases in visual plus auditory tracking scores (2%) but led to a 43% increase for auditory-only speech tracking. Regional cerebral blood flow measures indicated no substantial improvement of brain activation in the placebo group while both the extent and magnitude of primary and associative auditory cortex activations increased significantly with the pharmacologically enhanced treatment program.


CONCLUSIONS
These data support previous studies indicating an accelerated acquisition of speech and language abilities in stroke patients receiving traditional speech therapy in combination with d-amphetamine. Data, however, are preliminary and further study is warranted.
Tobey
Emily A
EA
Callier Advanced Hearing Research Center, The University of Texas at Dallas, Dallas, TX 75235, USA.
Devous
Michael D
MD
Buckley
Kristi
K
Overson
Gary
G
Harris
Thomas
T
Ringe
Wendy
W
Martinez-Verhoff
Julie
J
D000328:Adult; D000368:Aged; D001303:Auditory Cortex / Q000098:blood supply / Q000187:drug effects*; D000697:Central Nervous System Stimulants / Q000008:administration & dosage / Q000627:therapeutic use*; D002560:Cerebrovascular Circulation / Q000187:drug effects; D003054:Cochlear Implants; D003913:Dextroamphetamine / Q000008:administration & dosage / Q000627:therapeutic use*; D004311:Double-Blind Method; D005260:Female; D006319:Hearing Loss, Sensorineural / Q000188:drug therapy* / Q000534:rehabilitation / Q000601:surgery; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D013067:Speech Perception / Q000187:drug effects*; D013069:Speech Reception Threshold Test; D015899:Tomography, Emission-Computed, Single-Photon; D016896:Treatment Outcome
D000697:Central Nervous System Stimulants; D003913:Dextroamphetamine