Effects of Unilateral and Bilateral Cochlear Implantation on Cortical Activity Measured by an EEG Neuroimaging Method in Children

Bilateral implantation of a cochlear implant (CI) after a >2 year period of unilateral hearing with a second implant has been shown to result in altered latencies in brainstem responses in children with congenital deafness. In this thesis, a neural source localization method was developed to investigate the effects of unilateral CI use on cortical development after the implantation of a 2nd CI. The electroencephalography (EEG) source localization method is based on the linearly constrained minimum variance (LCMV) vector beamformer and utilizes null constraints to minimize the electrical artifact produced by the CI. The accuracy of the method was assessed and optimized through simulations and comparisons to beamforming with magnetoencephalography (MEG) data. After using cluster analyses to ensure that sources compared across subjects originate from the same neural generators, a study was done to examine the effects of unilateral CI hearing on hemispheric lateralization to monaural responses. It was found that a >2 year period of unilateral hearing results in expanded projections from the 1st implanted ear to the contralateral auditory area that is not reversed by implantation of a 2nd CI. A subsequent study was performed to examine the effects of unilateral CI hearing on the contributions of the 1st and 2nd implanted ears to the binaural response. It was found that in children with > 2 years of unilateral hearing, the binaural response is dominated by the 1st implanted ear. Together, these results suggest that the delay between the 1st and 2nd CI should be minimized in bilateral implantation to avoid dominance of auditory pathways from the 1st implanted ear. This dominance limits developmental competition from the 2nd CI and potentially contributes to poorer performance in speech detection in noise tasks.Ph