Abstract：
Many children with profound hearing loss have received cochlear implants (CI) to help restore some sense of hearing. There is, however, limited research on long-term neurocognitive outcomes in young adults who have grown up hearing through a CI. This study compared the cognitive outcomes of early-implanted (n = 20) and late-implanted (n = 21) young adult CI users, and typically hearing (TH) controls (n=56), all of whom were enrolled in college. Cognitive fluidity, nonverbal intelligence, and American Sign Language (ASL) comprehension were assessed, revealing no significant differences in cognition and nonverbal intelligence between the early and late-implanted groups. However, there was a difference in ASL comprehension, with the late-implanted group having significantly higher ASL comprehension. Although young adult CI users showed significantly lower scores in a working memory and processing speed task than TH age-matched controls, there were no significant differences in tasks involving executive function shifting, inhibitory control, and episodic memory between young adult CI and young adult TH participants. In an exploratory analysis of a subset of CI participants (n = 17) in whom we were able to examine crossmodal plasticity, we saw greater evidence of crossmodal recruitment from the visual system in late-implanted compared with early-implanted CI young adults. However, cortical visual evoked potential latency biomarkers of crossmodal plasticity were not correlated with cognitive measures or ASL comprehension. The results suggest that in the late-implanted CI users, early access to sign language may have served as a scaffold for appropriate cognitive development, while in the early-implanted group early access to oral language benefited cognitive development. Furthermore, our results suggest that the persistence of crossmodal neuroplasticity into adulthood does not necessarily impact cognitive development. In conclusion, early access to language - spoken or signed - may be important for cognitive development, with no observable effect of crossmodal plasticity on cognitive outcomes.
摘要：
许多患有严重听力损失的儿童接受了人工耳蜗植入（CI），以帮助恢复一些听觉。有,然而,对通过aCI听力长大的年轻人的长期神经认知结果的研究有限。这项研究比较了早期植入（n=20）和晚期植入（n=21）年轻成年CI使用者的认知结果，通常是听力(TH)控制(n=56)，他们都被大学录取了。认知流动性，非语言智力，和美国手语（ASL）的理解进行了评估，揭示早期和晚期植入组之间的认知和非语言智力没有显着差异。然而,对ASL的理解有所不同，晚期植入组的ASL理解力明显更高。尽管年轻的成年CI用户在工作记忆和处理速度任务中的得分明显低于TH年龄匹配的对照组，在涉及执行功能转变的任务中没有显着差异，抑制控制，年轻成人CI和年轻成人TH参与者之间的情景记忆。在对CI参与者子集（n=17）的探索性分析中，我们能够检查交叉模态可塑性，与早期植入CI的年轻人相比,我们发现更多证据表明,在植入晚期的年轻人中,视觉系统有跨模态募集.然而,跨模态可塑性的皮层视觉诱发电位潜伏期生物标志物与认知测量或ASL理解无关.结果表明，在植入后期的CI用户中，早期获得手语可能是适当认知发展的支架，而在早期植入组中，早期获得口头语言有利于认知发展。此外，我们的结果表明,跨模态神经可塑性持续到成年期并不一定会影响认知发育.总之,早期获得语言-口语或签名-可能对认知发展很重要，交叉模态可塑性对认知结果没有观察到的影响。
