Electrophysiological evidence for altered visual, but not auditory, selective attention in adolescent cochlear implant users

Frontal brain asymmetries as effective parameters to assess the quality of audiovisual stimuli perception in adult and young cochlear implant users

How is music perceived by cochlear implant (CI) users? This question arises as “the next step” given the impressive performance obtained by these patients in language perception. Furthermore, how can music perception be evaluated beyond self-report rating, in order to obtain measurable data? To address this question, estimation of the frontal electroencephalographic (EEG) alpha activity imbalance, acquired through a 19-channel EEG cap, appears to be a suitable instrument to measure the approach/withdrawal (AW index) reaction to external stimuli. Specifically, a greater value of AW indicates an increased propensity to stimulus approach, and vice versa a lower one a tendency to withdraw from the stimulus. Additionally, due to prelingually and postlingually deafened pathology acquisition, children and adults, respectively, would probably differ in music perception. The aim of the present study was to investigate children and adult CI users, in unilateral (UCI) and bilateral (BCI) implantation conditions, during three experimental situations of music exposure (normal, distorted and mute). Additionally, a study of functional connectivity patterns within cerebral networks was performed to investigate functioning patterns in different experimental populations. As a general result, congruency among patterns between BCI patients and control (CTRL) subjects was seen, characterised by lowest values for the distorted condition (vs. normal and mute conditions) in the AW index and in the connectivity analysis. Additionally, the normal and distorted conditions were significantly different in CI and CTRL adults, and in CTRL children, but not in CI children. These results suggest a higher capacity of discrimination and approach motivation towards normal music in CTRL and BCI subjects, but not for UCI patients. Therefore, for perception of music CTRL and BCI participants appear more similar than UCI subjects, as estimated by measurable and not self-reported parameters.

Selective attentional processes in cochlear implant recipients: Measurements of the attentional filter

In normal hearing subjects, detection of near-threshold tones in noise is influenced by signal certainty. Thus, tones that are presented more frequently than others, and/or are preceded by a clearly audible cue tone of the same frequency (target tones) are detected better than other tones (probe tones). This auditory attentional filter was examined in six cochlear implant (CI) recipients, using acoustic stimuli and direct programmed electrode stimulation. Three of the subjects showed no evidence of an attentional filter. Three subjects showed a relatively higher detection rate of the target frequency or electrode stimulated during the attentional task, and in two of these subjects the target benefit was influenced by stimulus certainty. The absence of an attentional filter in some CI recipients is consistent with suggestions that the attentional filter may be generated by efferent modulation of outer hair cells, which would presumably be absent in CI recipients, however, the presence of some frequency-selective attentional effects and a near-normal attentional filter in two CI subjects imply that central processes can modulate signal detection in CI recipients according to stimulus certainty. Such central processes might serve as a neural substrate to improve signal detection in CI recipients.

An exploratory study of visual sequential processing in children with cochlear implants

OBJECTIVE

The objective of the study was to compare visual sequential processing in school-age children with cochlear implants (CIs) and their normal-hearing (NH) peers. Visual sequential processing was examined using both behavioral and an event-related potential (ERP) measures.

METHODS

Eighteen children with CIs and nineteen children who had hearing within normal limits (NH) participated in the behavioral study. Subtests from the Test of Visual Perceptual Skills and the Sensory Integration and Praxis Test were administered to all children. ERP measures were collected from five children with CI and five age-matched peers. Peak latencies (N200 and P300) and reaction times for visual sequential processing were compared in these two groups.

RESULTS

The findings of the study revealed significant group differences in visual sequential memory and visuo-motor sequencing tasks suggesting that children with severe-profound hearing loss may have difficulties in visual sequential tasks. The study also revealed longer P300 latencies and longer reaction times for a visual sequential matching task in children with CI when compared to their NH peers suggesting slower or delayed processing of visual sequential stimuli.

CONCLUSIONS

This exploratory study involving behavioral and ERP measures showed that as a group, children with prelingual, severe-profound hearing loss who use CIs have difficulties with visual sequential processing. These findings may have implications for rehabilitation for children with hearing loss in the light of recent evidence that accurate and efficient processing of sequentially presented visual stimuli is important for language and reading outcomes.