Estimates of neural health using cochlear implant digital twins correlate with speech recognition
The cochlear implant is a neural prosthetic that uses an array of electrodes to directly stimulate auditory nerve fibers with electrical impulses. One factor that is known to impact outcomes is the quality of the electro-neural interface. In this work, we propose a pipeline that permits creating accurate and patient-specific digital twins that model the cochlear implant electro-neural interface. We leverage medical images and electrophysiological measurements from the patient's device for digital twin construction. We validate our digital twins by comparing predictions of neural response measurements to clinical measurements and speech recognition outcomes. Neural health estimated by the digital twin correlates strongly with word recognition rates (R=0.75, p<1e-5) in an analysis of 29 cases and sentence in noise recognition rates (R=0.78, p<1e-4) in an analysis of 21 cases. We also report preliminary findings with digital twin-based patient remapping with 6 subjects, where word recognition rates improved on average by 10 percentage points. These digital twins have the potential to provide clinicians with an unprecedented window into the electro-neural interface for individual cochlear implant recipients, which could lead to improved hearing outcomes when used as a foundation for program customization.