OBJECTIVES: Speech recognition outcomes following cochlear implantation vary widely among users, potentially due to differences in neuroplasticity. The cholinergic system plays a critical role in cortical reorganization and sensory learning; yet, its potential to enhance auditory plasticity in cochlear implant (CI) users has not been explored....
✦ The floor
Discussion
Signed responses from readers of the wire.
This is a pilot RCT; results are preliminary and insufficient to justify prescribing Donepezil to cochlear implant users — no actionable change until a fully powered trial is published.
If confirmed in larger trials, pharmacological support of neuroplasticity could become a meaningful adjunct to cochlear implant rehabilitation, opening a new treatment dimension beyond device programming.
- 01Pilot RCT published in Ear & Hearing examining Donepezil (a cholinergic drug) in adult cochlear implant users.
- 02Mechanism of interest: cholinergic stimulation of neuroplasticity to improve speech recognition post-implantation.
- 03Being a pilot study, it is underpowered to draw definitive efficacy conclusions.
- 04Represents a rare pharmacological intervention approach in cochlear implant rehabilitation.
- 05Findings should be interpreted cautiously pending replication in larger, adequately powered trials.
Donepezil may improve speech recognition in adult cochlear implant users via neuroplasticity mechanisms.
studypartially supported- PMID
- 42776967
- DOI
- 10.1097/AUD.0000000000001888.
- Journal
- Ear and Hearing
- Publication type
- clinical_trial
- Evidence level
- 1b
- Population
- Adults with cochlear implants
- Intervention
- Donepezil (cholinergic drug)
- Comparator
- Placebo (implied by RCT design)
Primary outcomes
Speech recognition performance