Bálint András, Wimmer Wilhelm, Rummel Christian, Caversaccio Marco, Weder Stefan
University of Bern, ARTORG Center for Biomedical Engineering Research, Hearing Research Laboratory, Bern, Switzerland.
Bern University Hospital, University of Bern, Inselspital, Department of ENT - Head and Neck Surgery, Bern, Switzerland.
Neurophotonics. 2026 Jan;13(Suppl 1):S13004. doi: 10.1117/1.NPh.13.S1.S13004. Epub 2025 Sep 11.
Cochlear implants (CIs) are a proven intervention for severe hearing loss; however, outcomes vary widely among CI recipients. Emerging evidence suggests that cortical adaptation to the electric hearing provided by CIs play a crucial role.
We investigate cortical brain activation differences in CI users, comparing individuals with good speech understanding (good performers, GP) to those with poor outcomes (poor performers, PP) alongside a control group with normal hearing (NH).
We recruited 46 CI users and 26 NH participants to perform a clinically adapted audiovisual speech comprehension task while we measured their brain activity using functional near-infrared spectroscopy (fNIRS). We corroborated our findings with objective and behavioral data.
Our findings showed distinct brain activation patterns associated with speech understanding. GP showed comparable brain activation patterns to NH in audio-only conditions, indicative of successful hearing rehabilitation. Further, both GP and PP participants showed an adaptive mechanism during visual speech processing. However, compared with GP, PP relied heavily on visual cues and showed altered neural resource allocation during audio-only conditions, potentially limiting their overall rehabilitation success.
fNIRS revealed significant differences in brain activation between GP and PP, highlighting the role of cortical factors in CI rehabilitation. Understanding these neural mechanisms has the potential to lead to better patient counseling, optimized postoperative management, and personalized therapeutic strategies to improve outcomes for CI users.
人工耳蜗（CI）是一种已被证实可用于治疗重度听力损失的干预手段；然而，人工耳蜗接受者的治疗效果差异很大。新出现的证据表明，大脑皮层对人工耳蜗提供的电刺激听力的适应起着关键作用。
我们研究人工耳蜗使用者大脑皮层的激活差异，将言语理解能力良好的个体（表现良好者，GP）与效果不佳的个体（表现不佳者，PP）进行比较，并与听力正常的对照组（NH）进行对比。
我们招募了46名人工耳蜗使用者和26名听力正常的参与者，让他们执行一项经过临床调整的视听言语理解任务，同时我们使用功能近红外光谱技术（fNIRS）测量他们的大脑活动。我们用客观和行为数据证实了我们的研究结果。
我们的研究结果显示了与言语理解相关的不同大脑激活模式。在仅听声音的条件下，表现良好者的大脑激活模式与听力正常者相当，表明听力康复成功。此外，表现良好者和表现不佳者在视觉言语处理过程中都表现出一种适应机制。然而，与表现良好者相比，表现不佳者严重依赖视觉线索，并且在仅听声音的条件下显示出神经资源分配的改变，这可能限制了他们整体的康复效果。
功能近红外光谱技术揭示了表现良好者和表现不佳者在大脑激活方面的显著差异，突出了皮层因素在人工耳蜗康复中的作用。了解这些神经机制有可能带来更好的患者咨询、优化的术后管理以及个性化的治疗策略，以改善人工耳蜗使用者的治疗效果。
