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Preoperative brain imaging using functional near-infrared spectroscopy helps predict cochlear implant outcome in deaf adults

Anderson, Carly A.; Wiggins, Ian M.; Kitterick, Padraig T.; Hartley, Douglas E.H.

Preoperative brain imaging using functional near-infrared spectroscopy helps predict cochlear implant outcome in deaf adults Thumbnail


Carly A. Anderson

Padraig T. Kitterick


Currently it is not possible to accurately predict how well a deaf individual will be able to understand speech when hearing is (re)introduced via a cochlear implant. Differences in brain organisation following deafness are thought to contribute to variability in speech understanding with a cochlear implant and may offer unique insights that could help to more reliably predict outcomes. An emerging optical neuroimaging technique, functional near-infrared spectroscopy (fNIRS), was used to determine whether a preoperative measure of brain activation could explain variability in CI outcomes and offer additional prognostic value above that provided by known clinical characteristics. Cross-modal activation to visual speech was measured in bilateral superior temporal cortex of profoundly deaf adults before cochlear implantation. Behavioural measures of auditory speech understanding were obtained in the same individuals following six months of cochlear-implant use. The results showed that stronger preoperative cross-modal activation of auditory brain regions by visual speech was predictive of poorer auditory speech understanding after implantation. Further investigation suggested that this relationship may have been driven primarily by group differences between pre- and post-lingually deaf individuals. Nonetheless, preoperative cortical imaging provided additional prognostic value above that of influential clinical characteristics, including the age-at-onset and duration of auditory deprivation, suggesting that objectively assessing the physiological status of the brain using fNIRS imaging preoperatively may support more accurate prediction of individual CI outcomes. Whilst activation of auditory brain regions by visual speech prior to implantation was related to the CI user’s clinical history of deafness, activation to visual speech did not relate to the future ability of these brain regions to respond to auditory speech stimulation with a CI. Greater preoperative activation of left superior temporal cortex by visual speech was associated with enhanced speechreading abilities, suggesting that visual-speech processing may help to maintain left temporal-lobe specialisation for language processing during periods of profound deafness.

Journal Article Type Article
Acceptance Date Jun 13, 2019
Online Publication Date Jul 8, 2019
Publication Date Oct 31, 2019
Deposit Date Jun 17, 2019
Publicly Available Date Jul 9, 2020
Journal Journal of the Association for Research in Otolaryngology
Print ISSN 1525-3961
Electronic ISSN 1438-7573
Publisher Springer Verlag
Peer Reviewed Peer Reviewed
Volume 20
Issue 5
Pages 511–528
Keywords Cochlear implantation; Cross-modal plasticity; Functional near-infrared spectroscopy; Prognostic imaging; Speechreading; Superior temporal cortex
Public URL
Publisher URL
Additional Information This is a post-peer-review, pre-copyedit version of an article published in Journal of the Association for Research in Otolaryngology. The final authenticated version is available online at:


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