Cortical activation during sound stimulation in cochlear implant users demonstrated by positron emission tomography.

Three patients with prelingual deafness and six patients with postlingual deafness using multichannel cochlear implants were examined by positron emission tomography using 15O-labeled water. Changes in regional cerebral blood flow (rCBF) were measured during three different sound stimuli: 1) with no sound stimulation, with the speech processor of the cochlear implant system switched off, 2) hearing white noise, and 3) hearing sequential Japanese sentences. In postlingually deaf patients, speech stimulation caused a significantly greater rCBF increase compared with noise stimulation in the left immediate auditory association area and the bilateral auditory association areas. In these patients, speech sound is thought to be processed by means of auditory cortices analogous to those in normal subjects. In contrast, in prelingually deaf patients, speech sound induced much less rCBF increase in auditory association cortices; this finding suggested underdevelopment of the neural network for complex sound analysis and speech sound recognition.