Researchers are taking a different approach to fighting hearing loss

Terry Gerton Certainly one of the topics that a lot of people are concerned about as they age is a loss of hearing. And there are advanced hearing aids, implants, but still it’s tough in noisy environments. ARPA-H has just rolled out a new program called the Hearing Enhancement Through Artificially Intelligent Neurotechnology — you guys get an A+ for acronyms — the HEARING Program. Tell me about what the HEARING Program is and what problem it’s trying to solve that current hearing aids can’t really address.

Calvin Roberts So as you said, hearing [loss] is ubiquitous among older people. And so we’re looking at at least 70 million Americans who are having trouble with their hearing. So what are their options? Well, really, the only option that’s out there is a hearing aid. And what does a hearing aids do? A hearing aid amplifies the sound, so as if they’re shouting in your ear. Now, for some people, that’s great. And particularly in a room that is quiet. So if you’re at home and you’re watching TV or you’re talking to someone one-on-one in a quiet environment, hearing aids are excellent. But the problem that most people have, and the number one complaint that I hear from people with hearing aids, is that they’re not helpful in noisy environments. And so it’s hard to separate speech from background noise. The people in this industry, they refer to this as the cocktail party dilemma, that if you’re in a noisy environment, you can’t separate the conversation that’s happening on one side of you from the conversations that’s happening on the other side of you, and it makes it hard. You know, Terry, there’s two situations that I talk about all the time. And one of them is you go to a wedding and the older people say, the band’s too loud. And the younger people say no, the band is not loud at all. And they’re both right. And then the other situation is the grandkids say, Grandpa, you’re not hearing a word I’m saying. And Grandpa says, yes, I hear everything. And they are both right. So, how could that be? How could that that they’re both right? Well, it starts out with, what’s the problem? What’s happening when someone loses their hearing? Well, usually what it is, is there is a very slow gradual deterioration of the inner ear, and the inner is where the sound gets we call it transduced, where it gets transformed from sound waves into an electrical type of signal, the type of signal that your brain can understand. So your ear turns the sound into a signal that goes to your brain, much as the way as your eyes take a light signal and transform that into a signal that goes through your brain. So what happens is that with this deterioration in your ear, now the signal to your brain gets deteriorated as well, because there’s not as good information coming in, can’t send as good a signal to you brain. So what does your brain do? Your brain turns up the gain. It just makes everything seem louder. And so the same sound to someone with ear deterioration actually sounds louder than to someone without. And so that’s why the band sounds louder to older people because the brain of older people has just turned up the gain and everything is louder in order to hear better. Right, so, what do we want to do? Here’s what we want do is we want to turn down the gain. We want the brain to go back to the way it was functioning when the person was younger. So how do we do that? We do that by improving the signal that’s coming to the brain. Because remember, that gain was turned up because of the fact that the signal wasn’t so good. If we can improve the signal, now the brain says, oh, I don’t have to work so hard, I don’t have to work so hard, I can turn down the gain and I can hear more normally. So what are we going to do? What we’re going to do is put a small little chip in your brain, a little computer chip in your brain. And what the chip is going to is it’s going to listen to what you want to hear. And then it’s gonna say, okay, here’s what you’re missing. Here’s what your ear is not being able to transmit to you that you want to hear. And so then what it’s going to do is it’s gonna be able to directly stimulate in your brain that which your ear can’t transmit. And so you’re gonna go back to having this full, rich sound like you had when you were a young person. And as that sound improves, now you won’t have to work so hard.

Terry Gerton Dr. Calvin Roberts is the hearing program manager at ARPA-H. That is fascinating, and I can think about lots of people who are gonna be very excited about that, but it also sounds like quite a challenge technologically. What’s the biggest obstacle that you’ll have to overcome in the technical space to go from just a hearing aid to a brain chip that’s gonna do this kind of work?

Calvin Roberts Well, there’s two things. One is the technical, and the second is the patient acceptance. And let’s do the patient acceptance first. In planning this program, we spoke to a lot of people who are having trouble with their hearing. And we said to them, would you be willing to have a chip put in your brain if it would help you hear? And our answer was almost universal. The people said, yes, I’d have a chip in my brain, but not if you had to drill a hole in my skull in order to get it there. So part of our program is to be able to deliver this chip where we want it in your brain without cutting a hole in your head. So, you say, well, how would you do that? You know, I think the analogy is to hearts. So it’s not that long ago, when someone wanted to repair a heart, they had to break open the chest, cut it open, do triple bypass type of thing, in order to get access. Today, how’s it done? People just feed little stents in through a artery or a vein, and they feed that stent in there, type of a thing, and it can do most of what a big surgery could do. Well, we’re gonna use that same idea and that same technology to be able to put these chips into the brain without having to drill a hole into the skull. And so hopefully, if we can do this and people go, oh, all right, this doesn’t seem so bad. I’d go for this, and if I really thought it was gonna help the hearing. Now, so that’s the patient acceptance. But your first question was, what’s the real technical challenge here? So the technical challenge is a couple. First of all, because we’re not looking for a treatment solely for people who have no hearing at all. What we wanna do is we wanna maximize that which you’re currently able to hear and just supplement it with that which you cannot hear and have both of these signals delivered to your brain at exactly the same time. So sync them, because you don’t want one signal coming. And then a half a second later another signal comes with delay, that that would be too hard. So you gotta get the signals to both get there at the same time. So that’s number one. Number two is you gotta realize that this is a journey and that people lose their hearing slowly over time. And so this is going to be a totally adaptable system so that as your ears change, as it becomes harder and harder for you to hear the chip will work and do more of this for you, so that you won’t really realize that your hearing has changed, because the quality of your hearing is gonna stay the same, even as you start losing more hearing over time.

Terry Gerton This is just the beginning of the program. You’ve just announced it. What sort of timeline are you looking on?

Calvin Roberts Yeah, so, it’s really exciting because there are so many people out there, really clever neuroscientists, technical people, computer wiz people who all have an interest in this. And at ARPA-H, we really specialize on programs that require teams of people. And so we’re asking people to put together teams of computer people and medical people and AI people and put them all together. And so we are expecting to get some really, really fabulous proposals.

Terry Gerton And once you get the proposals, is this a five-year program to prototype or what are you thinking about?

Calvin Roberts Yeah, so I think we’re looking at about four and a half years, in order to go from the beginning to get something that is ready for patients.

Terry Gerton Well, I’m hopeful after folks listen to this that you won’t at least have any shortage of applicants to be patients in the program.