Optogenetic stimulation of the auditory nerve

Patient perspectives on the need for improved hearing rehabilitation: A qualitative survey study of German cochlear implant users

Background

The electrical cochlear implant (eCI) partially restores hearing in individuals affected by profound hearing impairment (HI) or deafness. However, the limited resolution of sound frequency coding with eCIs limits hearing in daily situations such as group conversations. Current research promises future improvements in hearing restoration which may involve gene therapy and optical stimulation of the auditory nerve, using optogenetics. Prior to the potential clinical translation of these technologies, it is critical that patients are engaged in order to align future research agendas and technological advancements with their needs.

Methods

Here, we performed a survey study with hearing impaired, using an eCI as a means of hearing rehabilitation. We distributed a questionnaire to 180 adult patients from the University Medical Center Göttingen's Department of Otolaryngology who were actively using an eCI for 6 months or more during the time of the survey period. Questions revolved around patients needs, and willingness to accept hypothetical risks or drawbacks associated with an optical CI (oCI).

Results

Eighty-one participants responded to the questionnaire; 68% were greater than 60 years of age and 26% had bilateral eCIs. Participants expressed a need for improving the performance beyond that experienced with their current eCI. Primarily, they desired improved speech comprehension in background noise, greater ability to appreciate music, and more natural sound impression. They expressed a willingness for engaging with new technologies for improved hearing restoration. Notably, participants were least concerned about hypothetically receiving a gene therapy necessary for the oCI implant; but expressed greater reluctance to hypothetically receiving an implant that had yet to be evaluated in a human clinical trial.

Conclusion

This work provides a preliminary step in engaging patients in the development of a new technology that has the potential to address the limitations of electrical hearing rehabilitation.

Cochlear implants and other inner ear prostheses: today and tomorrow

Cochlear implants (CIs) are implantable auditory prostheses designed to restore access to sound in deaf individuals via direct electrical stimulation of the auditory nerve. While CIs have been successful in restoring speech perception to many deaf patients, outcomes are variable and speech recognition in noise remains a problem. This chapter will review the factors underlying this variability, and discuss significant recent innovations to address these issues including neural health preservation, characterization, and regeneration, and other inner ear prostheses. The emerging role of central auditory plasticity will also be discussed. Together, these advances will point to the likely future directions for advancing the next generation of CIs and other inner ear prostheses.

First biocompatibility margins for optical stimulation at the eardrum via 532-nm laser pulses in a mouse model

Hearing impairment affects ∼460 million people worldwide. Conservative therapies, such as hearing aids, bone conduction systems, and middle ear implants, do not always sufficiently compensate for this deficit. The optical stimulation is currently under investigation as an alternative stimulation strategy for the activation of the hearing system. To assess the biocompatibility margins of this emerging technology, we established a method applicable in whole-mount preparations of murine tympanic membranes (TM). We irradiated the TM of anesthetized mice with 532-nm laser pulses at an average power of 50, 89, 99, and 125 mW at two different locations of the TM and monitored the hearing function with auditory brainstem responses. Laser-power-dependent negative side effects to the TM were observed at power levels exceeding 89 mW. Although we did not find any significant negative effects of optical stimulation on the hearing function in these mice, based on the histology results further studies are necessary for optimization of the used parameters.

Frequency-specific activation of the peripheral auditory system using optoacoustic laser stimulation

Hearing impairment is one of the most common sensory deficits in humans. Hearing aids are helpful to patients but can have poor sound quality or transmission due to insufficient output or acoustic feedback, such as for high frequencies. Implantable devices partially overcome these issues but require surgery with limited locations for device attachment. Here, we investigate a new optoacoustic approach to vibrate the hearing organ with laser stimulation to improve frequency bandwidth, not requiring attachment to specific vibratory structures, and potentially reduce acoustic feedback. We developed a laser pulse modulation strategy and simulated its response at the umbo (1-10 kHz) based on a convolution-based model. We achieved frequency-specific activation in which non-contact laser stimulation of the umbo, as well as within the middle ear at the round window and otic capsule, induced precise shifts in the maximal vibratory response of the umbo and neural activation within the inferior colliculus of guinea pigs, corresponding to the targeted, modelled and then stimulated frequency. There was also no acoustic feedback detected from laser stimulation with our experimental setup. These findings open up the potential for using a convolution-based optoacoustic approach as a new type of laser hearing aid or middle ear implant.

Outlook and future of inner ear therapy

Drug delivery to the inner ear is an ideal method to treat a wide variety of otologic conditions. A broad range of potential applications is just beginning to be explored. New approaches combine principles of inner ear pharmacokinetics with emerging technologies of drug delivery including novel delivery systems, drug-device combinations, and new categories of drugs. Strategies include cell-specific targeting, manipulation of gene expression, local activation following systemic delivery, and use of stem cells, viral vectors, and gene editing systems. Translation of these therapies to the clinic remains challenging given the potential risks of intracochlear and intralabyrinthine trauma, our limited understanding of the etiologies of particular inner ear disorders, and paucity of accurate diagnostic tools at the cellular level. This review provides an overview of future methods, delivery systems, disease targets, and clinical considerations required for translation to clinical medicine.

High frequency neural spiking and auditory signaling by ultrafast red-shifted optogenetics

Optogenetics revolutionizes basic research in neuroscience and cell biology and bears potential for medical applications. We develop mutants leading to a unifying concept for the construction of various channelrhodopsins with fast closing kinetics. Due to different absorption maxima these channelrhodopsins allow fast neural photoactivation over the whole range of the visible spectrum. We focus our functional analysis on the fast-switching, red light-activated Chrimson variants, because red light has lower light scattering and marginal phototoxicity in tissues. We show paradigmatically for neurons of the cerebral cortex and the auditory nerve that the fast Chrimson mutants enable neural stimulation with firing frequencies of several hundred Hz. They drive spiking at high rates and temporal fidelity with low thresholds for stimulus intensity and duration. Optical cochlear implants restore auditory nerve activity in deaf mice. This demonstrates that the mutants facilitate neuroscience research and future medical applications such as hearing restoration.

Optogenetic applications would benefit from channelrhodopsins (ChRs) with faster photostimulation, increased tissue transparency and lower phototoxicity. Here, the authors develop fast red-shifted ChR variants and show the abilities for temporal precise spiking of cerebral interneurons and restoring auditory activity in deaf mice.

Optogenetic stimulation of the cochlea-A review of mechanisms, measurements, and first models

This review evaluates the potential of optogenetic methods for the stimulation of the auditory nerve and assesses the feasability of optogenetic cochlear implants (CIs). It provides an overview of all critical steps like opsin targeting strategies, how opsins work, how their function can be modeled and included in neuronal models and the properties of light sources available for optical stimulation. From these foundations, quantitative estimates for the number of independent stimulation channels and the temporal precision of optogenetic stimulation of the auditory nerve are derived and compared with state-of-the-art electrical CIs. We conclude that optogenetic CIs have the potential to increase the number of independent stimulation channels by up to one order of magnitude to about 100, but only if light sources are able to deliver confined illumination patterns independently and parallelly. Already now, opsin variants like ChETA and Chronos enable driving of the auditory nerve up to rates of 200 spikes/s, close to the physiological value of their maximum sustained firing rate. Apart from requiring 10 times more energy than electrical stimulation, optical CIs still face major hurdles concerning the safety of gene transfection and optrode array implantation, for example, before becoming an option to replace electrical CIs.

Optogenetics for neurodegenerative diseases

Neurodegenerative diseases are devastating conditions that lead to progressive degeneration of neurons. Neurodegeneration may result in ataxia, dementia, and muscle atrophies, etc. Despite enormous research efforts that have been made, there is lack of effective therapeutic interventions for most of these diseases. Optogenetics is a recently developed novel technique that combines optics and genetics to modulate the activity of specific neurons. Optogenetics has been implemented in various studies including neuropsychiatric disorders and neurodegenerative diseases. This review focuses on the recent advance in using this technique for the studies of common neurodegenerative diseases.

Temporal properties of inferior colliculus neurons to photonic stimulation in the cochlea

Infrared neural stimulation (INS) may be beneficial in auditory prostheses because of its spatially selective activation of spiral ganglion neurons. However, the response properties of single auditory neurons to INS and the possible contributions of its optoacoustic effects are yet to be examined. In this study, the temporal properties of auditory neurons in the central nucleus of the inferior colliculus (ICC) of guinea pigs in response to INS were characterized. Spatial selectivity of INS was observed along the tonotopically organized ICC. Trains of laser pulses and trains of acoustic clicks were used to evoke single unit responses in ICC of normal hearing animals. In response to INS, ICC neurons showed lower limiting rates, longer latencies, and lower firing efficiencies. In deaf animals, ICC neurons could still be stimulated by INS while unresponsive to acoustic stimulation. The site and spatial selectivity of INS both likely shaped the temporal properties of ICC neurons.

Optogenetic stimulation of the auditory pathway for research and future prosthetics

Sound is encoded by spiral ganglion neurons (SGNs) in the hearing organ, the cochlea, with great temporal, spectral and intensity resolution. When hearing fails, electric stimulation by implanted prostheses can partially restore hearing. Optical stimulation promises a fundamental advance of hearing restoration over electric prostheses since light can be conveniently focused and hence might dramatically improve frequency resolution of sound encoding. Combining optogenetic manipulation of neurons with innovative optical stimulation technology promises versatile spatiotemporal stimulation patterns in the auditory system. Therefore, using optical stimulation of SGNs also has great potential for auditory research. Here, I review recent progress in optogenetic stimulation of the auditory system and its potential for future application in research and hearing restoration.