Genetic biomarkers of the central auditory system as clinical predictors of cochlear implant outcomes

The National Institute on Deafness and Other Communication Disorders awarded Vanderbilt University Medical Center $158,696 on December 31, 2026, under the Research Related to Deafness and Communication Disorders program (CFDA 93.173) to identify genetic biomarkers of central auditory structures that predict individual cochlear implant outcomes in adults with moderate to profound hearing loss.

The fellowship research addresses the gap that 80 percent of variance in speech recognition outcomes after implantation remains unexplained by existing clinical models, which focus primarily on peripheral auditory factors rather than central auditory pathway contributions. The investigator will conduct two aims: determining the impact of genetic variation affecting central auditory structures on post-operative speech recognition in adult cochlear implant users, and determining the impact of variants in genes of neurotrophic factors broadly expressed throughout the peripheral and central auditory system, with the hypothesis that pathogenic variants in both categories are associated with poorer implant-aided outcomes. The fellowship will provide training in gene expression analysis, variant annotation, and machine learning to establish an independent research program leveraging genetics to optimize hearing rehabilitation. Identification of these biomarkers will enable precision medicine approaches to device programming, rehabilitation, and counseling strategies.

Performance occurs at Forest Hills, Tennessee, with a period extending from December 31, 2026, through June 30, 2029. The assistance type is a Project Grant.

Abstract

Cochlear implants (CIS) are the gold standard for restoring hearing in individuals with moderate to profound hearing loss, yet 80% of the variance in speech recognition outcomes remains unexplained. This GAP presents significant challenges for optimizing treatment strategies for CI users. Understanding the central auditory pathway is critical, as IT directly influences CI outcomes but is often overlooked in existing clinical models that focus primarily on peripheral auditory factors. This fellowship aims to harness genetics as a clinically translatable tool to identify biomarkers of central auditory structures and their adaptive plasticity, explaining individual differences in CI performance. Aim 1 will determine the impact of genetic variation affecting central auditory structures on post-operative speech recognition in adult CI users, hypothesizing that pathogenic variants in these structures are associated with poorer CI-aided outcomes. Aim 2 will determine the impact of variants in genes of neurotrophic factors broadly expressed throughout the peripheral and central auditory system, hypothesizing that pathogenic variants in these genes are associated with poorer CI-aided outcomes. This study addresses the critical need to clarify the central auditory pathway's contributions to CI outcomes through an innovative use of a clinical tool: genetics. Identification of these biomarkers will enable a precision medicine approach to CI care, informing individualized rehabilitation, device programming, and counseling strategies. The proposed training will equip me with skills in gene expression analysis, variant annotation, and machine learning, preparing me to establish an independent research program focused on leveraging genetics to optimize hearing rehabilitation. Successful completion will advance understanding of central auditory contributions to CI outcomes and directly support precision medicine approaches for individuals with hearing loss.