Cross-modal reorganization in cochlear implant users: Auditory cortex contributes to visual face processing.

There is converging evidence that the auditory cortex takes over visual functions during a period of auditory deprivation. A residual pattern of cross-modal take-over may prevent the auditory cortex to adapt to restored sensory input as delivered by a cochlear implant (CI) and limit speech intelligibility with a CI. The aim of the present study was to investigate whether visual face processing in CI users activates auditory cortex and whether this has adaptive or maladaptive consequences. High-density electroencephalogram data were recorded from CI users (n=21) and age-matched normal hearing controls (n=21) performing a face versus house discrimination task. Lip reading and face recognition abilities were measured as well as speech intelligibility. Evaluation of event-related potential (ERP) topographies revealed significant group differences over occipito-temporal scalp regions. Distributed source analysis identified significantly higher activation in the right auditory cortex for CI users compared to NH controls, confirming visual take-over. Lip reading skills were significantly enhanced in the CI group and appeared to be particularly better after a longer duration of deafness, while face recognition was not significantly different between groups. However, auditory cortex activation in CI users was positively related to face recognition abilities. Our results confirm a cross-modal reorganization for ecologically valid visual stimuli in CI users. Furthermore, they suggest that residual takeover, which can persist even after adaptation to a CI is not necessarily maladaptive.

Comparing Binaural Pre-processing Strategies II: Speech Intelligibility of Bilateral Cochlear Implant Users.

Several binaural audio signal enhancement algorithms were evaluated with respect to their potential to improve speech intelligibility in noise for users of bilateral cochlear implants (CIs). 50% speech reception thresholds (SRT50) were assessed using an adaptive procedure in three distinct, realistic noise scenarios. All scenarios were highly nonstationary, complex, and included a significant amount of reverberation. Other aspects, such as the perfectly frontal target position, were idealized laboratory settings, allowing the algorithms to perform better than in corresponding real-world conditions. Eight bilaterally implanted CI users, wearing devices from three manufacturers, participated in the study. In all noise conditions, a substantial improvement in SRT50 compared to the unprocessed signal was observed for most of the algorithms tested, with the largest improvements generally provided by binaural minimum variance distortionless response (MVDR) beamforming algorithms. The largest overall improvement in speech intelligibility was achieved by an adaptive binaural MVDR in a spatially separated, single competing talker noise scenario. A no-pre-processing condition and adaptive differential microphones without a binaural link served as the two baseline conditions. SRT50 improvements provided by the binaural MVDR beamformers surpassed the performance of the adaptive differential microphones in most cases. Speech intelligibility improvements predicted by instrumental measures were shown to account for some but not all aspects of the perceptually obtained SRT50 improvements measured in bilaterally implanted CI users.

Rapid bilateral improvement in auditory cortex activity in postlingually deafened adults following cochlear implantation.

OBJECTIVE: Cochlear implants (CIs) can partially restore hearing, but the cortical changes underlying auditory rehabilitation are not well understood. METHODS: This prospective longitudinal study used electroencephalography (EEG) to examine the temporal dynamics of changes in the auditory cortex contralateral and ipsilateral to the CI. Postlingually deafened CI recipients (N=11; mean: 59years) performed an auditory frequency discrimination task after <1week, 8weeks, 15weeks, and 59weeks of CI use. RESULTS: The CI users revealed a remarkable improvement in auditory discrimination ability which was most pronounced over the first eight weeks of CI experience. At the same time, CI users developed N1 auditory event-related potentials (AEP) with significantly enhanced amplitude and decreased latency, both in the auditory cortex contralateral and ipsilateral to the CI. A relationship was found between the duration of deafness and the ipsilateral AEP latency. CONCLUSIONS: Postlingually deafened adult CI users show rapid adaptation of the bilateral auditory cortex. Cortical plasticity is limited after long duration of auditory deprivation. SIGNIFICANCE: The finding of rapid and limited cortical changes in adult CI recipients may be of clinical relevance and can help estimate the role of plasticity for therapeutic gain.