How Cambridge researchers hope VR headsets and games will transform lives of young people with cochlear implants

Continuing our support for the Love Research campaign, run by three Cambridgeshire NHS trusts to highlight the benefits of medical research for all, editor Paul Brackley explores an ongoing clinical trial for young people with hearing loss.

Virtual reality (VR) headsets and immersive games are being tested in a clinical trial to see if they can help transform the lives of young people with cochlear implants.

The 100th participant in the trial, called BEARS (for ‘Both Ears’), has recently been recruited following applied research grant funding from the National Institute of Health and Care.

The young people involved are aged 8 to 16 and all have severe to profound hearing loss.

They use cochlear implants in both ears - known as bilateral - to make the sounds around them clearer.

Each year, more than 400 children in the UK alone are fitted with bilateral cochlear implants, at a cost of about £40,000 per patient.

The implants bypass the damaged portions of the ear and directly stimulate the auditory nerve through small electrodes.

This provides clearer sound and enables better understanding of speech but to work effectively, the brain must be trained continuously to adapt to and recognise the sounds that it is picking up.

Many users of bilateral cochlear implants report difficulties with ‘spatial hearing’, meaning they find it hard to detect where sounds come from, which makes it hard for them to listen in noisy environments.

“When we asked teenagers with bilateral cochlear implants about their hearing, they said their ears felt ‘lop-sided’ – they didn’t hear balanced sounds across both ears. This might be so bad that they took one implant out altogether,” explained BEARS lead investigator Deborah Vickers, principal research associate in the University of Cambridge’s Department of Clinical Neurosciences. “This is a huge challenge for young people at a critical stage in their lives.”

The BEARS training package has been developed under the leadership of Imperial College London’s Lorenzo Picinali and deploys a series of specialised VR games that challenge the young people to localise sounds around them. The aim is to train their brains to use the information from both cochlear implants working together.

The clinical trial is co-led by Dan Jiang, of Guy’s and St Thomas’ Foundation Trust, and involves collaborators from five universities with 11 clinical sites taking part, including Cambridge University Hospitals.

Some 384 young people will be recruited to the trial, which will compare the effects of using BEARS training at home for at least one hour a week over a three-month period against receiving usual care.

A follow up after 12 months will explore if any initial effects for improvements in speech perception and spatial hearing have been maintained.

Among the VR games included is target practice, with levels getting harder as visual cues are removed.

“Eventually, you just have to shoot in the direction where the sound is coming from, so it’s all about training and localisation and using the two ears together,” said Debi.

Another game involves taking orders from customers in a noisy pizza parlour.

“It’s a much more interesting way for young people to do their hearing rehabilitation and enables them to take control,” she noted.

Results from the trial are not expected until 2026, but could prove life changing for young people with hearing loss.

The hope is it will help them have hearing that is as natural as possible, equipping them for the next stage of their lives, such as starting work or continuing in education.

It could also pave the way for similar hearing rehabilitation programmes for older patients or those using different types of hearing devices, such as hearing aids.

Debi said: “Many adults with bilateral implants – and even some with hearing aids – are interested in taking part. Going forwards, this could be useful training for a large range of people with hearing devices.”

For more information on the trial, or to find out how to take part, visit https://www.guysandstthomasbrc.nihr.ac.uk/microsites/bears/