Auditory cross-modal reorganization in cochlear implant users indicates audio-visual integration

There is clear evidence for cross-modal cortical reorganization in the auditory system of post-lingually deafened cochlear implant (CI) users. A recent report suggests that moderate sensori-neural hearing loss is already sufficient to initiate corresponding cortical changes. To what extend these changes are deprivation-induced or related to sensory recovery is still debated. Moreover, the influence of cross-modal reorganization on CI benefit is also still unclear. While reorganization during deafness may impede speech recovery, reorganization also has beneficial influences on face recognition and lip-reading. As CI users were observed to show differences in multisensory integration, the question arises if cross-modal reorganization is related to audio-visual integration skills. The current electroencephalography study investigated cortical reorganization in experienced post-lingually deafened CI users (n = 18), untreated mild to moderately hearing impaired individuals (n = 18) and normal hearing controls (n = 17). Cross-modal activation of the auditory cortex by means of EEG source localization in response to human faces and audio-visual integration, quantified with the McGurk illusion, were measured. CI users revealed stronger cross-modal activations compared to age-matched normal hearing individuals. Furthermore, CI users showed a relationship between cross-modal activation and audio-visual integration strength. This may further support a beneficial relationship between cross-modal activation and daily-life communication skills that may not be fully captured by laboratory-based speech perception tests. Interestingly, hearing impaired individuals showed behavioral and neurophysiological results that were numerically between the other two groups, and they showed a moderate relationship between cross-modal activation and the degree of hearing loss. This further supports the notion that auditory deprivation evokes a reorganization of the auditory system even at early stages of hearing loss