Johan H M Frijns

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Verified

Johan verified their affiliation via an institutional email.

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• MD PhD
• Professor (Full) at Leiden University Medical Centre

We present NeuroVoc, a flexible model-agnostic vocoder framework that reconstructs acoustic waveforms from simulated neural activity patterns using an inverse Fourier transform. The system applies straightforward signal processing to neurogram representations, time-frequency binned outputs from auditory nerve fiber models. Crucially, the model arch...

Objective: To assess the impact of cochlear implantation (CI) and speech perception outcomes on the quality of life (QoL) of adult CI users and their communication partners (CP) one-year post-implantation. Design: This research is part of a prospective multicenter study in The Netherlands, called SMILE (Societal Merit of Intervention for hearing...

Speech separation approaches for single-channel, dry speech mixtures have significantly improved. However, real-world spatial and reverberant acoustic environments remain challenging, limiting the effectiveness of these approaches for assistive hearing devices like cochlear implants (CIs). To address this, we quantify the impact of real-world acous...

Objective: Measuring listening effort using pupillometry is challenging in cochlear implant (CI) users. We assess three validated speech tests (Matrix, LIST, and DIN) to identify the optimal speech material for measuring peak-pupil-dilation (PPD) in CI users as a function of signal-to-noise ratio (SNR). Design: Speech tests were administered in...

Empathy plays a crucial role in children’s social-emotional development. There is an increasing trend in recent studies to recognize empathy as a multi-dimensional construct, consisting of three distinct hierarchical levels: emotion contagion, attention to others’ feelings and prosocial behaviors (Hoffman, Motiv Emot, 14(2), 151–172, 1990). The pre...

Objectives: This study aims to synthesize current knowledge and outcomes related to pediatric auditory brainstem implantation (ABI) in children with severe inner ear malformations (IEMs). It highlights the clinical management practices, challenges, and potential future directions for consensus development in this field. Methods: A systematic rev...

Here, we describe two congenitally deaf male siblings with the same compound heterozygotic, likely pathogenic mutations in the FGF3 gene, associated with the labyrinthine aplasia, microtia and microdontia (LAMM) syndrome. Both children had bilateral cochleovestibular aplasia, precluding cochlear implantation. The elder brother received an auditory...

Introduction Various factors, including an aging population and expanding eligibility criteria, may increase the demand for cochlear implants (CIs), potentially resulting in longer waiting times. In most Dutch CI centers, the time between referral and surgery exceeds 6 months. Clinical experience suggests that during the waiting period for cochlear...

Purpose Knowledge of the cochlear anatomy in individual patients is helpful for improving electrode selection and placement during cochlear implantation, as well as in surgical planning. The aim of this study was to develop a model-free automated segmentation algorithm to obtain 3D surfaces from clinical computed tomography (CT) scans that describe...

Objectives We investigated whether listening effort is dependent on task difficulty for cochlear implant (CI) users when using the Matrix speech-in-noise test. To this end, we measured peak pupil dilation (PPD) at a wide range of signal to noise ratios (SNR) by systematically changing the noise level at a constant speech level, and vice versa. Des...

Despite the spread of novel-generation cochlear-implant (CI) magnetic systems, access to magnetic resonance imaging (MRI) for CI recipients is still limited due to safety concerns. The aim of this study is to assess and record the experiences of Hires Ultra 3D (Advanced Bionics) recipients who underwent an MRI examination. A multicentric European s...

This study introduces and evaluates the PHAST+ model, part of a computational framework designed to simulate the behavior of auditory nerve fibers in response to the electrical stimulation from a cochlear implant. PHAST+ incorporates a highly efficient method for calculating accommodation and adaptation, making it particularly suited for simulation...

Introduction: Cochlear implantation is the standard treatment for severe to profound hearing loss. While cochlear implant (CI) users can communicate effectively in quiet environments, speech understanding in noise remains challenging. Bimodal hearing, combining a CI in one ear and a hearing aid (HA) in the other, has shown advantages over unilater...

Objective To evaluate the clinical applicability of a semiautomatic radiological tool for scalar translocation detection. Study Design Retrospective study. Setting Tertiary care academic center. Patients We included 104 patients implanted with 116 HiFocus Mid-Scala electrode arrays between January 2013 and September 2016. Intervention Cochlear...

Objectives: Spectro-temporal ripple tests are commonly used in cochlear implant (CI) research as language-independent indicators of speech recognition (in noise) or as stand-alone tests. Test-retest reliability of these tests has been scarcely documented. We evaluated the test-retest reliability of spectral-temporally modulated ripple test (SMRT)...

Performing simulations with a realistic biophysical auditory nerve fiber model can be very time-consuming, due to the complex nature of the calculations involved. Here, a surrogate (approximate) model of such an auditory nerve fiber model was developed using machine learning methods, to perform simulations more efficiently. Several machine learning...

Triphasic pulse stimulation can prevent unpleasant facial nerve stimulation in cochlear implant users. Using electromyographic measurements on facial nerve effector muscles, previous studies have shown that biphasic and triphasic pulse stimulations produce different input-output functions. However, little is known about the intracochlear effects of...

Introduction: Contralateral routing of signals (CROS) overcomes the head shadow effect by redirecting speech signals from the contralateral ear to the better-hearing cochlear implant (CI) ear. Here we tested the performance of an adaptive monaural beamformer (MB) and a fixed binaural beamformer (BB) using the CROS system of Advanced Bionics. Meth...

Performing simulations with a realistic biophysical auditory nerve fiber model can be very time consuming, due to the complex nature of the calculations involved. Here, a surrogate (approximate) model of such an auditory nerve fiber model was developed using machine learning methods, to perform simulations more efficiently. Several machine learning...

Objectives: This study compared the performance of a dynamic partial tripolar cochlear implant speech encoding strategy termed dynamic current focusing (DCF) to monopolar stimulation (MP) using spectro-temporal, temporal, and speech-in-noise recognition testing. Design: DCF is a strategy that utilizes tripolar or high partial tripolar stimulatio...

Objectives: Many studies have assessed the performance of individuals with cochlear implants (CIs) with electrically evoked compound action potentials (eCAPs). These eCAP-based studies have focused on the amplitude information of the response, without considering the temporal firing properties of the excited auditory nerve fibers (ANFs), such as n...

Objectives We examined which preoperative diagnostic measure is most suited to serve as a selection criterion to determine adult cochlear implantation (CI) candidacy. Design Preoperative diagnostic measures included pure tone audiometry (PTA; 0.5, 1, 2, 4 kHz), speech perception tests (SPT) unaided with headphones and with best-aided hearing aids...

Objective To determine the benefit of sequential cochlear implantation after a long inter-implantation interval in children with bilateral deafness receiving their second implant between 5 and 18 years of age. Study design Prospective cohort-study. Setting Tertiary multicenter. Patients 85 children with bilateral deafness and unilateral implanta...

Objective: We sought to validate our proposed tool for estimating channel discrimination of cochlear implant (CI) users along the full electrode array and to assess associations between place-pitch discrimination and speech perception. Design: In two tests, participants identified one stimulus (probe) as the odd-one-out compared with two referen...

Naturalistic playground observations are a rich source of information when studying the social interactions of preschool children. On the playground, children can interact with their peers, explore different places and activities, and engage in different types of play. For deaf and hard of hearing (DHH) children, interactions at a playground can be...

We have investigated the effectiveness of three noise-reduction algorithms, namely an adaptive monaural beamformer (MB), a fixed binaural beamformer (BB), and a single-microphone stationary-noise reduction algorithm (SNRA) by assessing the speech reception threshold (SRT) in a group of 15 bimodal cochlear implant users. Speech was presented frontal...

Background The refractory recovery function (RRF) measures the electrically evoked compound action potential (eCAP) in response to a second pulse (probe) after masking by a first pulse (masker). This RRF is usually used to assess the refractory properties of the electrically stimulated auditory nerve (AN) by recording the eCAP amplitude as a functi...

Objective : Spread of excitation (SOE) in cochlear implants (CI) is a measure linked to the specificity of the electrode-neuron interface. The SOE can be estimated objectively by electrically evoked compound action potential (eCAP) measurements, recorded with the forward-masking paradigm in CI recipients. The eCAP amplitude can be plotted as a func...

Hypothesis: Insertion speed during cochlear implantation determines the risk of cochlear trauma. By slowing down insertion speed tactile feedback is improved. This is highly conducive to control the course of the electrode array along the cochlear contour and prevent translocation from the scala tympani to the scala vestibuli. Background: Limiti...

Hearing loss in patients with vestibular schwannoma (VS) is commonly attributed to mechanical compression of the auditory nerve, though recent studies suggest that this retrocochlear pathology may be augmented by cochlear damage. Although VS-associated loss of inner hair cells, outer hair cells, and spiral ganglion cells has been reported, it is un...

Background and Introduction: Idiopathic sudden sensorineural hearing loss (ISSNHL) is characterized by rapid onset, typically unilateral presentation, and variable recovery. This case-control observational study aimed to improve patient counseling by objectively characterizing long-term hearing loss progression following ISSNHL, using sequential au...

The main aim of this computational modelling study was to test the validity of the hypothesis that sensitivity to the polarity of cochlear implant stimulation can be interpreted as a measure of neural health. For this purpose, the effects of stimulus polarity on neural excitation patterns were investigated in a volume conduction model of the implan...

For deaf and hard-of-hearing (DHH) children living in an environment where their access to linguistic input and social interactions is compromised, learning emotions could be difficult, which may further affect social functioning. To understand the role of emotion in DHH children’s social life, this study investigated emotional functioning (i.e., e...

Objectives: Video head impulse test (v-HIT) is a quick, non-invasive and relatively cheap test to evaluate vestibular function compared to the caloric test. The latter is, however, needed to decide on the optimal side to perform cochlear implantation to avoid the risk on inducing a bilateral vestibular areflexia. This study evaluates the effectiven...

Children with hearing loss (HL) are at risk for a lower educational achievement. This longitudinal study compared the school career of a nationwide Dutch cohort with and without HL based on descriptive data of the governmental authority Statistics Netherlands. From 2008 to 2018, 3,367,129 children, of whom 1,193 used cochlear implants (CIs) and 8,8...

Introduction: Contralateral routing of signals (CROS) can be used to eliminate the head shadow effect. In unilateral cochlear implant (CI) users, CROS can be achieved with placement of a microphone on the contralateral ear, with the signal streamed to the CI ear. CROS was originally developed for unilateral CI users without any residual hearing in...

Objectives: Speech understanding in noise is difficult for patients with a cochlear implant. One common and disruptive type of noise is transient noise. We have tested transient noise reduction (TNR) algorithms in cochlear implant users to investigate the merits of personalizing the noise reduction settings based on a subject's own preference. De...

Objectives: Misplacement of the electrode array is associated with impaired speech perception in patients with cochlear implants (CIs). Translocation of the electrode array is the most common misplacement. When a CI is translocated, it crosses the basilar membrane from the scala tympani into the scala vestibuli. The position of the implant can be...

Empathy enables people to share, understand, and show concern for others’ emotions. However, this capacity may be more difficult to acquire for children with hearing loss, due to limited social access, and the effect of hearing on empathic maturation has been unexplored. This four-wave longitudinal study investigated the development of empathy in c...

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Objectives: While the costs and outcomes of cochlear implantation (CI) have been widely assessed, most of these analyses were solely performed from the perspective of healthcare costs. This study assesses the costs and benefits of CI in the Netherlands from a broader societal perspective, including health outcomes, healthcare cost, educational cos...

The electrically evoked compound action potential (eCAP) has been widely studied for its clinical value for the evaluation of the surviving auditory nerve (AN) cells. However, many unknowns remain about the temporal firing properties of the AN fibers that underlie the eCAP in CI recipients. These temporal properties may contain valuable information...

Objectives: The primary objective of this study is to identify the biographic, audiologic, and electrode position factors that influence speech perception performance in adult cochlear implant (CI) recipients implanted with a device from a single manufacturer. The secondary objective is to investigate the independent association of the type of ele...

Objectives: For children to understand the emotional behavior of others, the first two steps involve emotion encoding and emotion interpreting, according to the Social Information Processing model. Access to daily social interactions is prerequisite to a child acquiring these skills, and barriers to communication such as hearing loss impede this a...

An Auditory Brainstem Implant (ABI) is a technique developed for patients with severe hearing loss. The ABI consists of a microphone and speech processor located on the scalp, which is connected to a transmitting and receiving coil and electrode on the brain stem placed in the skull. Eligible for an ABI are adults with cochlea and acoustic nerve da...

Despite the introduction of many new sound-coding strategies speech perception outcomes in cochlear implant listeners have leveled off. Computer models may help speed up the evaluation of new sound- coding strategies, but most existing models of auditory nerve responses to electrical stimulation include limited temporal detail, as the effects of lo...

Cochlear implant (CI) users have more difficulty understanding speech in temporally modulated noise than in steady-state (SS) noise. This is thought to be caused by the limited low-frequency information that CIs provide, as well as by the envelope coding in CIs that discards the temporal fine structure (TFS). Contralateral amplification with a hear...

Huisartsen zien weliswaar niet vaak patiënten met plotseling gehoorverlies (sudden deafness), maar het is voor het beleid van groot belang dat ze onderscheid kunnen maken tussen geleidings- en perceptiestoornissen van het gehoor. Met de juiste stemvork en de proeven van Weber en Rinne is dat in de dagelijkse praktijk goed te doen.

Die unerwünschte Co-Stimulation des N. facialis (engl. Facial-Nerve-Stimulation, FNS) in Cochlea-Implantatträgern kann durch Anwendung triphasischer Stimulationspulse mit kathodischer erster Phase signifikant reduziert werden. Die Reduktion der FNS, welche durch triphasische Stimulation zur Verfügung steht, kann jedoch für manche Patienten nicht au...

Background and Introduction: Vestibular schwannomas (VSs) are the most common tumors of the cerebellopontine angle, typically presenting unilaterally with ipsilateral sensorineural hearing loss (SNHL). The mechanism of tumor-induced hearing loss has recently been shown to be related to secreted tumor factors, in addition to mechanical compression o...

Objectives: The ability to perceive soft speech by cochlear implant (CI) users is restricted in part by the inherent system noise produced by the speech processor, and in particular by the microphone(s). The algorithm "SoftVoice" (SV) was developed by Advanced Bionics to enhance the perception of soft speech by reducing the system noise in speech...

Traumatic brain injury (TBI) is a devastating event for which current therapies are limited. Stem cell transplantation may lead to recovery of function via different mechanisms, such as cell replacement through differentiation, stimulation of angiogenesis and support to the microenvironment. Adult hair follicle bulge-derived stem cells (HFBSCs) pos...

Objective The electrically evoked compound action potential (eCAP) has been widely studied for its clinical value in evaluating cochlear implants (CIs). However, to date, single-fiber recordings have not been recorded from the human auditory nerve, and many unknowns remain about the firing properties that underlie the eCAP in patients with CIs. In...

Objectives: The impact of the newly introduced cochlear implantation criteria of the United Kingdom and Flanders (Dutch speaking part of Belgium) was examined in the patient population of a tertiary referral center in the Netherlands. We compared the patients who would be included/excluded under the new versus old criteria in relation to the actua...

Objective Chronic suppurative otitis media (CSOM) is a chronic infectious disease with worldwide prevalence that causes hearing loss and decreased quality of life. As current (antibiotic) treatments often unsuccessful and antibiotic resistance is emerging, alternative agents and/or strategies are urgently needed. We considered the synthetic antimic...

Intracochlear electrocochleography (ECochG) is a potential tool for the assessment of residual hearing in cochlear implant users during implantation and acoustical tuning postoperatively. It is, however, unclear how these ECochG recordings from different locations in the cochlea depend on the stimulus parameters, cochlear morphology, implant design...

Objectives: Phantom electrode stimulation was developed for cochlear implant (CI) systems to provide a lower pitch percept by stimulating more apical regions of the cochlea, without inserting the electrode array deeper into the cochlea. Phantom stimulation involves simultaneously stimulating a primary and a compensating electrode with opposite pol...

No assessment tools are available to measure shame and guilt in children who are deaf or hard of hearing (DHH), while these self-conscious emotions might play a role in the frequently noted social and behavioral problems in this group. Therefore, the aim of this study was to validate the Brief Shame and Guilt Questionnaire (BSGQ) in DHH children. I...

This study examined the quantity and quality of parental linguistic input to toddlers with moderate hearing loss (MHL) compared with toddlers with normal hearing (NH). The linguistic input to eighteen toddlers with MHL and twenty-four toddlers with NH was examined during a 10-minute free-play activity in their home environment. Results showed that...

Objectives: To compare the quality of life (QoL) of children with hearing loss (HL) and children with normal hearing (NH) and to examine how the QoL of children with HL changes over time, considering language skills, type of hearing device, degree of HL, and type of education. Methods and materials: This longitudinal study included 62 children wit...

Objectives: To evaluate long-term language development in children with prelingual deafness who received auditory brainstem implants (ABIs) compared with children who received cochlear implants (CIs) at the same hospital. Additional non-auditory disabilities were taken into account. Study Design: Retrospective cohort study. Setting: Tertiary refer...

In dit hoofdstuk worden de anatomie, embryologie en fysiologie van het nauw met elkaar verbonden auditief en vestibulair systeem behandeld. Geluid brengt via oorschelp en gehoorgang (uitwendig oor) het trommelvlies in trilling en via de gehoorbeenketen (middenoor) komt de trilling in de cochlea (binnenoor) waar de energie omgezet wordt in elektrisc...

Electrically evoked compound action potentials (eCAPs) are measurements of the auditory nerve's response to electrical stimulation. ECAP amplitudes during pulse trains can exhibit temporal alternations. The magnitude of this alternation tends to diminish over time during the stimulus. How this pattern relates to the temporal behavior of nerve fiber...

Objective: This study aimed to evaluate a more energy-efficient dynamic current focussing (DCF) speech-processing strategy after long-term listening experience. In DCF, tripolar stimulation is used near the threshold and loudness is controlled by the compensation coefficient σ. A recent acute pilot study showed improved spectral-temporally modulate...

Objective: The reliability of the electrically evoked compound action potential (eCAP) threshold depends on its precision and accuracy. The precision of the eCAP threshold reflects its variability, while the accuracy of the threshold shows how close it is to the actual value. The objective of this study was to determine the test/retest variability...

Objective: To test the channel discrimination of cochlear implant (CI) users along all contacts of the electrode array and assess whether this is related to speech perception. Design: CI recipients were tested with a custom-made channel discrimination test. They were asked to distinguish a target stimulus from two reference stimuli in a three-alter...

Recent studies have shown that applying triphasic instead of biphasic stimulation pulses can significantly reduce the FNS (Bahmer & Baumann, 2016; Bahmer et al., 2017). An electrophysiological measure is used to clarify whether there is a difference between biphasic (BP) and triphasic pulses (TP) inside of the cochlea in terms of spread of excitati...

Objective: The primary aim of this study was to longitudinally compare the behavioral and self-reported outcomes of simultaneous bilateral cochlear implantation (simBiCI) and sequential BiCI (seqBiCI) in adults with severe-to-profound postlingual sensorineural hearing loss. Design: This study is a multicenter randomized controlled trial with a 4-ye...

Stem‐cell‐based therapy may be used to replace damaged or lost neurons in the cochlear nerve of patients suffering from severe‐to‐profound sensorineural hearing loss. In order to achieve functional recovery in future clinical trials, knowledge about survival of grafted cells and their differentiation into functional neurons is a prerequisite. This...

Slechthorenden ervaren als belangrijkste probleem niet zozeer het feit dat ze niet langer de zachtere geluiden horen, maar vooral dat ze meer moeite hebben met het verstaan van spraak. Omdat gehoorverlies een beperking is die van persoon tot persoon verschilt, zijn aan de persoon aangepaste oplossingen vereist. De oplossingen hiervoor zijn hoortoes...

Het oor is het orgaan waarmee geluidsgolven worden opgevangen waarna ze door de hersenen worden ervaren als geluid. Het gehoororgaan wordt op anatomische, embryologische en fysiologische gronden onderverdeeld in uitwendig oor, middenoor en binnenoor. Het uitwendig oor bestaat uit oorschelp en gehoorgang en speelt een rol in het opvangen en het door...

Purpose Relative to normally hearing (NH) peers, the speech of children with cochlear implants (CIs) has been found to have deviations such as a high fundamental frequency, elevated jitter and shimmer, and inadequate intonation. However, two important dimensions of prosody (temporal and spectral) have not been systematically investigated. Given tha...

The perception and production of emotional and linguistic (focus) prosody were compared in children with cochlear implants (CI) and normally hearing (NH) peers. Thirteen CI and thirteen hearing-age-matched school-aged NH children were tested, as baseline, on non-verbal emotion understanding, non-word repetition, and stimulus identification and nami...

Round window membrane (RWM) application of ouabain is known to selectively destroy type I spiral ganglion cells (SGCs) in cochleas of several rodent species, while leaving hair cells intact. This protocol has been used in rats and Mongolian gerbils, but observations in the guinea pig are conflicting. This is why we reinvestigated the effect of ouab...

Emotional functioning plays a crucial role in the social development of children and adolescents. We examined the extent to which emotion control was related to the quality of friendships in pre-adolescents with and without hearing loss. We tested 350 pre-adolescents (75 deaf/hard of hearing in mainstream education (DHHm), 48 deaf/hard of hearing i...

Objectives: In an attempt to improve spectral resolution and speech intelligibility, several current focusing methods have been proposed to increase spatial selectivity by decreasing intracochlear current spread. For example, tripolar stimulation administers current to a central electrode and uses the two flanking electrodes as the return pathway,...

Objectives: This study determined the relationship between preoperative phoneme and word scores and the gain in speech perception after cochlear implantation in a large cohort of patients. The authors aimed to define evidence-based selection criteria for cochlear implantations in adults with postlingual deafness. Design: This retrospective study...

Objective: To answer the dilemma clinician's face when deciding between cochlear implant (CI) and auditory brainstem implant (ABI) treatment options in patients with cochlear nerve deficiency (CND). Study design: Case study supplemented with literature review and meta-analysis. Setting: Tertiary referral center. Patient(s): Child with CHARGE...

Objective: An amplitude growth function (AGF) shows the amplitude of an electrically evoked compound action potential (eCAP) as a function of the stimulation current. AGFs can be used to derive the eCAP threshold, which represents the minimum amount of current needed to elicit a measurable eCAP. eCAP thresholds have been widely used clinically to,...

ImportanceThere is an ongoing global discussion on whether or not bilateral cochlear implantation should be standard care for bilateral deafness. Contrary to unilateral cochlear implantation, however, little is known about the effect of bilateral cochlear implantation on tinnitus.Objective To investigate tinnitus outcomes 1 year after bilateral coc...

Stem-cell-based repair of auditory neurons may represent an attractive therapeutic option to restore sensorineural hearing loss. Hair-follicle-bulge-derived stem cells (HFBSCs) are promising candidates for this type of therapy, because they (1) have migratory properties, enabling migration after transplantation, (2) can differentiate into sensory n...

Objective: Cochlear implants (CIs) have dramatically improved the lives of children who are deaf or hard of hearing; however, little is known about its implications for preventing the development of psychiatric symptoms in this at-risk population. This is the first longitudinal study to examine the early manifestation of emotional and behavioral d...

Previous studies have demonstrated no improved or deteriorated speech intelligibility with the HiResolution Fidelity 120™ speech coding strategy (HiResF120) over the original HiRes strategy. Improved spectral and deteriorated temporal sensitivities have been shown, making it plausible that the beneficial effect in the spectral domain was offset by...