Kuzma Strelnikov

Visual activity predicts auditory recovery from deafness after adult cochlear implantation

Modern cochlear implantation technologies allow deaf patients to understand auditory speech; however, the implants deliver only a coarse auditory input and patients must use long-term adaptive processes to achieve coherent percepts. In adults with post-lingual deafness, the high progress of speech recovery is observed during the first year after cochlear implantation, but there is a large range of variability in the level of cochlear implant outcomes and the temporal evolution of recovery. It has been proposed that when profoundly deaf subjects receive a cochlear implant, the visual cross-modal reorganization of the brain is deleterious for auditory speech recovery. We tested this hypothesis in post-lingually deaf adults by analysing whether brain activity shortly after implantation correlated with the level of auditory recovery 6 months later. Based on brain activity induced by a speech-processing task, we found strong positive correlations in areas outside the auditory cortex. The highest positive correlations were found in the occipital cortex involved in visual processing, as well as in the posterior-temporal cortex known for audio-visual integration. The other area, which positively correlated with auditory speech recovery, was localized in the left inferior frontal area known for speech processing. Our results demonstrate that the visual modalitys functional level is related to the proficiency level of auditory recovery. Based on the positive correlation of visual activity with auditory speech recovery, we suggest that visual modality may facilitate the perception of the words auditory counterpart in communicative situations. The link demonstrated between visual activity and auditory speech perception indicates that visuoauditory synergy is crucial for cross-modal plasticity and fostering speech-comprehension recovery in adult cochlear-implanted deaf patients.

Does Brain Activity at Rest Reflect Adaptive Strategies? Evidence from Speech Processing after Cochlear Implantation

In functional neuroimaging studies, task-related activity refers to the signal difference between the stimulation and rest conditions. We asked whether long-term changes in the sensory environment may affect brain activity at rest. To answer this question, we compared regional cerebral blood flow between a group of normally hearing controls and a group of cochlear-implanted (CI) deaf patients. Here we present evidence that long-term alteration of auditory experience, such as profound deafness followed by partial auditory recuperation through cochlear implantation, leads to functional cortical reorganizations at rest. Without any visual or auditory stimulation, CI subjects showed changes of cerebral blood flow in the visual, auditory cortex, Broca area, and in the posterior temporal cortex with an increment of activity in these areas from the time of activation of the implant to less than a year after the implantation.

Improvement in Speech-Reading Ability by Auditory Training: Evidence from Gender Differences in Normally Hearing, Deaf and Cochlear Implanted Subjects.

Several neuropsychological and neuroimaging studies on gender differences in speech processing lead to the suggestion that women use the neural network of predictive and integrative analysis of speech to a larger extent than men. During speech-reading there is indeed a lack of reliable clues for word recognition which should emphasize predictive and integrative strategies of the brain. Our study aimed to explore gender differences in deaf and cochlear implanted (CI) patients at different levels during speech-reading, for words or phonemes, that we consider, correspond to increased involvement of predictive and integrative analysis. We collected speech-reading scores in a control group of normally hearing subjects (n=42) and in a group of deaf patients - who are good speech-readers - tested before, early after and late after cochlear implantation (n=97). Patient groups were almost equally distributed between follow-up and new patients. In normally hearing controls, women speech-read words better than men. This difference was also observed in all patients but not in experienced cochlear implant users. We did not observe a gender difference during speech-reading of isolated phonemes neither for controls nor for patients. We conclude that the better speech-reading ability of women for words but not for phonemes is in line with their greater use of predictive and integrative strategies for speech processing. Furthermore, we observed a progressive cross-modal compensation in male CI users after cochlear implantation which suggests a synergetic perceptual facilitation involving the visual and the recovering auditory modalities. This could lead to an improved performance in both auditory and visual modalities, the latter being constantly recruited to complement the crude information provided by the implant. Altogether, our data provide insights into cross-modal compensation in the adult brain following sensory privation.

Role of speechreading in audiovisual interactions during the recovery of speech comprehension in deaf adults with cochlear implants.

Speechreading is an important form of communicative activity that improves social adaptation in deaf adults. Cochlear implantation allows interaction between the visual speechreading abilities developed during deafness and the auditory sensory experiences acquired through use of the cochlear implant. Crude auditory information provided by the implant is analyzed in parallel with conjectural information from speechreading, thus creating new profiles of audiovisual integration with implications for brain plasticity. Understanding the peculiarities of change in speechreading after cochlear implantation may improve our understanding of brain plasticity and provide useful information for functional rehabilitation of implanted patients. In this article, we present a generalized review of our recent studies and indicate perspectives for further research in this domain.

Effect of Audiovisual Training on Monaural Spatial Hearing in Horizontal Plane

The article aims to test the hypothesis that audiovisual integration can improve spatial hearing in monaural conditions when interaural difference cues are not available. We trained one group of subjects with an audiovisual task, where a flash was presented in parallel with the sound and another group in an auditory task, where only sound from different spatial locations was presented. To check whether the observed audiovisual effect was similar to feedback, the third group was trained using the visual feedback paradigm. Training sessions were administered once per day, for 5 days. The performance level in each group was compared for auditory only stimulation on the first and the last day of practice. Improvement after audiovisual training was several times higher than after auditory practice. The group trained with visual feedback demonstrated a different effect of training with the improvement smaller than the group with audiovisual training. We conclude that cross-modal facilitation is highly important to improve spatial hearing in monaural conditions and may be applied to the rehabilitation of patients with unilateral deafness and after unilateral cochlear implantation.

Quality of Life and Auditory Performance in Adults with Asymmetric Hearing Loss

We evaluated the relationship between binaural hearing deficits and quality of life. The study included 49 adults with asymmetric hearing loss (AHL), and 11 adult normal-hearing listeners (NHL) served as controls. Speech reception thresholds (SRT) were assessed with the French Matrix Test. Quality of life was evaluated with the Speech, Spatial and Qualities of Hearing Scale (SSQ) and the Glasgow Health Status Inventory. Speech recognition in noise was significantly poorer for AHL subjects [-0.12 dB signal-to-noise ratio (SNR) in dichotic (with speech presented to the poorer ear and noise to the better ear), -1.72 dB in diotic and -6.84 dB in reverse-dichotic conditions] compared to NHL (-4.98 dB in diotic and -9.58 dB in dichotic conditions). Scores for quality-of-life questionnaires were significantly below norms. Significant correlations were found between the SRT for the dichotic condition and the SSQ total score (r = -0.38, p = 0.01), and pure-tone average thresholds for both groups.

PET-imaging of brain plasticity after cochlear implantation.

In this article, we review the PET neuroimaging literature, which indicates peculiarities of brain networks involved in speech restoration after cochlear implantation. We consider data on implanted patients during stimulation as well as during resting state, which indicates basic long-term reorganisation of brain functional architecture. On the basis of our analysis of neuroimaging literature and considering our own studies, we indicate that auditory recovery in deaf patients after cochlear implantation partly relies on visual cues. The brain develops mechanisms of audio-visual integration as a strategy to achieve high levels of speech recognition. It turns out that this neuroimaging evidence is in line with behavioural findings of better audiovisual integration in these patients. Thus, strong visually and audio-visually based rehabilitation during the first months after cochlear implantation would significantly improve and fasten the functional recovery of speech intelligibility and other auditory functions in these patients. We provide perspectives for further neuroimaging studies in cochlear implanted patients, which would help understand brain organisation to restore auditory cognitive processing in the implanted patients and would potentially suggest novel approaches for their rehabilitation. This article is part of a Special Issue entitled .

Increased audiovisual integration in cochlear‐implanted deaf patients: independent components analysis of longitudinal positron emission tomography data

It has been demonstrated in earlier studies that patients with a cochlear implant have increased abilities for audio‐visual integration because the crude information transmitted by the cochlear implant requires the persistent use of the complementary speech information from the visual channel. The brain network for these abilities needs to be clarified. We used an independent components analysis (ICA) of the activation (H215O) positron emission tomography data to explore occipito‐temporal brain activity in post‐lingually deaf patients with unilaterally implanted cochlear implants at several months post‐implantation (T1), shortly after implantation (T0) and in normal hearing controls. In between‐group analysis, patients at T1 had greater blood flow in the left middle temporal cortex as compared with T0 and normal hearing controls. In within‐group analysis, patients at T0 had a task‐related ICA component in the visual cortex, and patients at T1 had one task‐related ICA component in the left middle temporal cortex and the other in the visual cortex. The time courses of temporal and visual activities during the positron emission tomography examination at T1 were highly correlated, meaning that synchronized integrative activity occurred. The greater involvement of the visual cortex and its close coupling with the temporal cortex at T1 confirm the importance of audio‐visual integration in more experienced cochlear implant subjects at the cortical level.

Sex-dependent modulation of activity in the neural networks engaged during emotional speech comprehension

Studies using event related potentials have shown that men are more likely than women to rely on semantic cues when understanding emotional speech. In a previous functional Magnetic Resonance Imaging (fMRI) study, using an affective sentence classification task, we were able to separate areas involved in semantic processing and areas involved in the processing of affective prosody (Beaucousin et al., 2007). Here we searched for sex-related differences in the neural networks active during emotional speech processing in groups of men and women. The ortholinguistic abilities of the participants did not differ when evaluated with a large battery of tests. Although the neural networks engaged by men and women during emotional sentence classification were largely overlapping, sex-dependent modulations were detected during emotional sentence classification, but not during grammatical sentence classification. Greater activity was observed in men, compared with women, in inferior frontal cortical areas involved in emotional labeling and in attentional areas. In conclusion, at equivalent linguistic abilities and performances, men activate semantic and attentional cortical areas to a larger extent than women during emotional speech processing.

Effects of vocoding and intelligibility on the cerebral response to speech

BackgroundDegrading speech through an electronic synthesis technique called vocoding has been shown to affect cerebral processing of speech in several cortical areas. However, it is not clear whether the effects of speech degradation by vocoding are related to acoustical degradation or by the associated loss in intelligibility. Using vocoding and a parametric variation of the number of frequency bands used for the encoding, we investigated the effects of the degradation of auditory spectral content on cerebral processing of intelligible speech (words), unintelligible speech (words in a foreign language), and complex environmental sounds.ResultsVocoding was found to decrease activity to a comparable degree for intelligible and unintelligible speech in most of the temporal lobe. Only the bilateral posterior temporal areas showed a significant interaction between vocoding and intelligibility, with a stronger vocoding-induced decrease in activity for intelligible speech. Comparisons to responses elicited by environmental sounds showed that portions of the temporal voice areas (TVA) retained their greater responses to voice even under adverse listening conditions. The recruitment of specific networks in temporal regions during exposure to degraded speech follows a radial and anterior-posterior topography compared to the networks recruited by exposure to speech that is not degraded.ConclusionsDifferent brain networks are involved in vocoded sound processing of intelligible speech, unintelligible speech, and non-vocal sounds. The greatest differences are between speech and environmental sounds, which could be related to the distinctive temporal structure of speech sounds.