Using non-invasive brain stimulation to promote auditory neuroplasticity in the setting of hearing intervention: A scoping review.
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2026-02
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Cochlear implants (CI) have revolutionized our ability to treat severe sensorineural hearing loss (HL), yet there is substantial variability in speech perception outcomes. This may be due, in part, to the central nervous system's (CNS) response to HL, which is variable in extent and reversibility. Compensatory responses to HL mediated by neuroplasticity within the auditory CNS and other functional regions may interfere with perceptual, integrative and/or cognitive processes required to develop new listening skills with a CI. Non-invasive brain stimulation (NIBS) approaches offer a means to modulate the excitability of the brain and associated Hebbian processes that promote neuroplasticity. NIBS may therefore provide a means to increase gains in listening and communication function for individuals undergoing hearing rehabilitation. A narrative review is first performed to synthesize current evidence on CNS neuroplasticity associated with HL and intervention, and explores the conceptual rationale for applying NIBS to enhancing rehabilitation outcomes using contemporary hearing technology and auditory training. A formal scoping review was then done to identify studies that look at the use of NIBS in hearing rehabilitation in those with HL. Currently, clinical data for NIBS in patients with HL remain scarce. At present, conclusions regarding NIBS efficacy for improving hearing outcomes are premature; however, emerging findings provide a promising direction for future translational research. Limitations include the lack of standardized stimulation protocols and insufficient longitudinal data. Addressing these gaps will be essential to determine whether NIBS can safely and effectively enhance relevant neuroplasticity that improves rehabilitation outcomes for individuals with HL.
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Wright, Joshua M, Lawrence Gregory Appelbaum, Sherri L Smith, Tobias Overath, Samantha Kaplan, Matthew Cooper, Ofri Ronen, Tamar Tobi, et al. (2026). Using non-invasive brain stimulation to promote auditory neuroplasticity in the setting of hearing intervention: A scoping review. Hearing research, 474. p. 109576. 10.1016/j.heares.2026.109576 Retrieved from https://hdl.handle.net/10161/34339.
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Tobias Overath
Research in our lab investigates how sound is processed in the human brain. More specifically, we study the acoustic building blocks that must be assembled in complex listening situations, such as when we engage in a conversation or listen to a symphony. One branch of our research program centers on the neural representation of fundamental acoustic parameters, e.g. pitch and timbre, and the neural mechanisms for detecting meaningful acoustic changes of such parameters within an auditory scene. A second branch of our research investigates auditory perception at a linguistic level and addresses the transformation from speech-specific acoustic analysis to speech-specific linguistic analysis, with an emphasis on temporal integration constants. We employ a combination of behavioral and neuroimaging methods (fMRI, EEG) to elucidate the underlying neural processes in human auditory cortex with high spatial and temporal precision.
Angel V Peterchev
Dr. Peterchev directs the Brain Stimulation Engineering Lab (BSEL) which focuses on the development, modeling, and application of devices and paradigms for transcranial brain stimulation. Transcranial brain stimulation involves non-invasive delivery of fields (e.g., electric and magnetic) to the brain that modulate neural activity. It is widely used as a tool for research and a therapeutic intervention in neurology and psychiatry, including several FDA-cleared indications. BSEL develops devices for transcranial magnetic stimulation (TMS) and other forms of magnetic stimulation such as magnetogenetics that leverage design techniques from power electronics and computational electromagnetics to enable more flexible stimulus control, focal stimulation, and quiet operation. We also deploy these devices in experimental studies to characterize and optimize the brain response to TMS. Another line of work is multi-scale computational models that couple simulations of the electromagnetic fields, single neuron responses, and neural population modulation induced by electric and magnetic brain stimulation. These models are calibrated and validated with experimental neural recordings through various collaborations. Apart from understanding of mechanisms, we develop modeling, algorithmic, and targeting tools for response estimation, dose individualization, and precise localization of transcranial brain stimulation using advanced techniques such as artificial neural networks and machine learning. Moreover, BSEL is involved in the integration of transcranial brain stimulation with robotics, neuronavigation, intracranial electrophysiology recordings, and imaging modalities such as functional magnetic resonance imaging (fMRI) and electroencephalography (EEG), as well as the evaluation of the safety of device–device interactions, for example between transcranial stimulators and implants. Importantly, we collaborate widely with neuroscientists and clinicians at Duke and other institutions to translate developments from the lab to research and clinical applications. For over 18 years, BSEL has been continuously supported with multiple NIH grants as well as funding by DARPA, NSF, Brain & Behavior Research Foundation, Coulter Foundation, Duke Institute for Brain Sciences, MEDx, Duke University Energy Initiative, industry, and philanthropic gifts. Further, some of our technology has been commercialized, for example as ElevateTMS cTMS, or incorporated in free software packages, such as SimNIBS and SAMT. Dr. Peterchev received the John Rothwell Award in 2024 for “excellence in non-invasive brain stimulation research that stimulates further work at a higher scientific level” and was elevated to IEEE Fellow in 2026.
Howard Wayne Francis
Dr. Howard W. Francis, is the Richard Hall Chaney, Sr professor of Otolaryngology and inaugural Chair of the Department of Head and Neck Surgery & Communication Sciences (HNS&CS) at Duke University Medical Center, where he is also the Chief of the Medical Staff of Duke University Hospital. He is a practicing neurotologist with research interests including practice innovations and clinical outcomes in the delivery of hearing health care. He is a senior editor of the Cummings Otolaryngology-Head and Neck Surgery Text, is a Director on the American Board of Otolaryngology-Head and Neck Surgery, a past member of the Otolaryngology Residency Review Committee of the ACGME, and a member of the Board of Directors of the Alexander Graham Bell Association for the Deaf and Hard of Hearing. Dr. Francis is a past president of the Society of University Otolaryngologists, past Education Director of the American Neurotology Society, and a recipient of the 2020 American Academy of Otolaryngology-Head and Neck Surgery Presidential Citation.
After completing his high-school education in Jamaica, and his bachelor’s degree at the University of Southern California in Los Angeles, Dr. Francis earned his medical degree from the Harvard-MIT division of Health, Science and Technology at Harvard Medical School, and then completed his internship, residency and fellowship training at the Johns Hopkins Hospital. He completed his Master’s in Business Administration with a focus in medical services management at the Johns Hopkins Carey Business School. After 19 years on the faculty at Johns Hopkins during which he served as Residency Program Director, Director of the Johns Hopkins Listening Center and Vice Director of the Department, he was appointed chief of HNS&CS at Duke in March 2017, and then the first Chair of the new Department in 2019.
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