Evidence of visual crossmodal reorganization positively relates to speech outcomes in cochlear implant users

Paul, Brandon T.; Bajin, Münir Demir; Uzelac, Mila; Chen, Joseph; Le, Trung; Lin, Vincent; Dimitrijevic, Andrew

doi:10.1038/s41598-022-22117-z

Cited by 9 publications

(5 citation statements)

References 63 publications

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“…Recent investigators ( Chen et al, 2017 ; Fullerton et al, 2023 ; Paul et al, 2022 ) have questioned the classical view ( Lee et al, 2001 ) that cross-modal plasticity negatively affects speech performances of participants with CI. Cortical reorganization following CI may not always prevent the auditory cortex from responding to auditory stimuli ( Land et al, 2016 ).…”

Section: Discussionmentioning

confidence: 99%

Motor Processing in Children With Cochlear Implants as Assessed by Functional Near-Infrared Spectroscopy

Alemi,

Wolfe,

Neumann

et al. 2023

Percept Mot Skills

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Auditory-motor and visual-motor networks are often coupled in daily activities, such as when listening to music and dancing; but these networks are known to be highly malleable as a function of sensory input. Thus, congenital deafness may modify neural activities within the connections between the motor, auditory, and visual cortices. Here, we investigated whether the cortical responses of children with cochlear implants (CI) to a simple and repetitive motor task would differ from that of children with typical hearing (TH) and we sought to understand whether this response related to their language development. Participants were 75 school-aged children, including 50 with CI (with varying language abilities) and 25 controls with TH. We used functional near-infrared spectroscopy (fNIRS) to record cortical responses over the whole brain, as children squeezed the back triggers of a joystick that vibrated or not with the squeeze. Motor cortex activity was reflected by an increase in oxygenated hemoglobin concentration (HbO) and a decrease in deoxygenated hemoglobin concentration (HbR) in all children, irrespective of their hearing status. Unexpectedly, the visual cortex (supposedly an irrelevant region) was deactivated in this task, particularly for children with CI who had good language skills when compared to those with CI who had language delays. Presence or absence of vibrotactile feedback made no difference in cortical activation. These findings support the potential of fNIRS to examine cognitive functions related to language in children with CI.

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Section: Discussionmentioning

confidence: 99%

Motor Processing in Children With Cochlear Implants as Assessed by Functional Near-Infrared Spectroscopy

Alemi,

Wolfe,

Neumann

et al. 2023

Percept Mot Skills

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“…Our findings are also consistent with more recent studies supporting a beneficial role of visual language input on auditory outcomes in CI users. A recent study by Paul et al (2022) used electroencephalography to measure crossmodal visual responses in auditory cortex and related these to speech-in-noise perceptual abilities. Those authors found that CI users with higher speech perception scores demonstrated stronger responses in auditory cortex to visual stimuli.…”

Section: Discussionmentioning

confidence: 99%

“…Most previous studies of AV speech recognition in clinical populations of patients with moderate-to-profound HL have been done in established postlingually deaf adult CI users with substantial experience using their devices (Rabinowitz et al 1992;Kaiser et al 2003;Hay-McCutcheon et al 2005;Rouger et al 2007;Desai et al 2008;Strelnikov et al 2009;Altieri et al 2011;Stevenson et al 2017;Schreitmüller et al 2018). In those studies, investigators have found that experienced CI users (ECIs) demonstrated greater benefits from visual cues than normal-hearing peers during AV speech recognition (Desai et al 2008;Rouger et al 2008;Leybaert & LaSasso 2010).…”

Section: Introductionmentioning

confidence: 99%

Audiovisual Processing Skills Before Cochlear Implantation Predict Postoperative Speech Recognition in Adults

Moberly,

Pisoni,

Tamati

2023

Ear &Amp; Hearing

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Objectives: Adults with hearing loss (HL) demonstrate greater benefits of adding visual cues to auditory cues (i.e., “visual enhancement” [VE]) during recognition of speech presented in a combined audiovisual (AV) fashion when compared with normal-hearing peers. For patients with moderate-to-profound sensorineural HL who receive cochlear implants (CIs), it is unclear whether the restoration of audibility results in a decrease in the VE provided by visual cues during AV speech recognition. Moreover, it is unclear whether increased VE during the experience of HL before CI is beneficial or maladaptive to ultimate speech recognition abilities after implantation. It is conceivable that greater VE before implantation contributes to the enormous variability in speech recognition outcomes demonstrated among patients with CIs. This study took a longitudinal approach to test two hypotheses: (H1) Adult listeners with HL who receive CIs would demonstrate a decrease in VE after implantation; and (H2) The magnitude of pre-CI VE would predict post-CI auditory-only speech recognition abilities 6 months after implantation, with the direction of that relation supporting a beneficial, redundant, or maladaptive effect on outcomes. Design: Data were collected from 30 adults at two time points: immediately before CI surgery and 6 months after device activation. Pre-CI speech recognition performance was measured in auditory-only (A-only), visual-only, and combined AV fashion for City University of New York (CUNY) sentences. Scores of VE during AV sentence recognition were computed. At 6 months after CI activation, participants were again tested on CUNY sentence recognition in the same conditions as pre-CI. H1 was tested by comparing post- versus pre-CI VE scores. At 6 months of CI use, additional open-set speech recognition measures were also obtained in the A-only condition, including isolated words, words in meaningful AzBio sentences, and words in AzBio sentences in multitalker babble. To test H2, correlation analyses were performed to assess the relation between post-CI A-only speech recognition scores and pre-CI VE scores. Results: Inconsistent with H1, after CI, participants did not demonstrate a significant decrease in VE scores. Consistent with H2, preoperative VE scores positively predicted postoperative scores of A-only sentence recognition for both sentences in quiet and in babble (rho = 0.40 to 0.45, p < 0.05), supporting a beneficial effect of pre-CI VE on post-CI auditory outcomes. Pre-CI VE was not significantly related to post-CI isolated word recognition. The raw pre-CI CUNY AV scores also predicted post-CI A-only speech recognition scores to a similar degree as VE scores. Conclusions: After implantation, CI users do not demonstrate a decrease in VE from before surgery. The degree of VE during AV speech recognition before CI positively predicts A-only sentence recognition outcomes after implantation, suggesting the potential value of AV testing of CI patients preoperatively to help predict and set expectations for postoperative outcomes.

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“…Contrary to previous concerns about potential interference between visual sign language and auditory processing via CI, emerging studies have highlighted a different perspective. This updated discourse centers on the idea that signed language, as a visual modality, may not necessarily hinder the development of crucial auditory skills in CI users ( Cardin et al, 2016 ; Corina et al, 2017 ; Paul et al, 2022 ; see Land et al, 2016 , for animals). Instead, as speech inherently is multimodal (i.e., auditory speech signal is accompanied by visual of mouth movements), incorporating signed language alongside CI use may serve as a vital bridge between different sensory experiences, enhancing comprehension and communication.…”

Section: Introductionmentioning

confidence: 99%

Impact of ASL Exposure on Spoken Phonemic Discrimination in Adult CI Users: A Functional Near-Infrared Spectroscopy Study

Nematova,

Zinszer,

Morlet

et al. 2024

Neurobiology of Language

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We examined the impact of exposure to a signed language (ASL) at different ages on the neural systems that support spoken language phonemic discrimination in deaf individuals with cochlear implants (CIs). Deaf CI users (N = 18, age = 18–24 years) who were exposed to a signed language at different ages and hearing individuals (N = 18, age = 18–21 years) completed a phonemic discrimination task in a spoken native (English) and non-native (Hindi) language while undergoing functional near-infrared spectroscopy (fNIRS) neuroimaging. Behaviorally, deaf CI users who received a CI early versus later in life showed better English phonemic discrimination, albeit phonemic discrimination was poor relative to hearing individuals. Importantly, the age of exposure to ASL was not related to phonemic discrimination. Neurally, early-life language exposure, irrespective of modality, was associated with greater neural activation of left-hemisphere language areas critically involved in phonological processing during the phonemic discrimination task in deaf CI users. In particular, early exposure to ASL was associated with increased activation in the left hemisphere’s classic language regions for native versus non-native language phonemic contrasts for deaf CI users who received a CI later in life. For deaf CI users who received a CI early in life, the age of exposure to ASL was not related to neural activation during phonemic discrimination. Together, the findings suggest that early signed language exposure does not negatively impact spoken language processing in deaf CI users but may instead potentially offset the negative effects of language deprivation that deaf children without any signed language exposure experience prior to implantation. This empirical evidence aligns with and lends support to recent perspectives regarding the impact of ASL exposure in the context of CI usage.

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Evidence of visual crossmodal reorganization positively relates to speech outcomes in cochlear implant users

Cited by 9 publications

References 63 publications

Motor Processing in Children With Cochlear Implants as Assessed by Functional Near-Infrared Spectroscopy

Motor Processing in Children With Cochlear Implants as Assessed by Functional Near-Infrared Spectroscopy

Audiovisual Processing Skills Before Cochlear Implantation Predict Postoperative Speech Recognition in Adults

Impact of ASL Exposure on Spoken Phonemic Discrimination in Adult CI Users: A Functional Near-Infrared Spectroscopy Study

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