Single-sided deaf subjects with a cochlear implant (CI) provide the unique opportunity to compare central auditory processing of the electrical input (CI ear) and the acoustic input (normal-hearing, NH, ear) within the same individual. In these individuals, sensory processing differs between their two ears, while cognitive abilities are the same irrespectively of the sensory input. To better understand perceptual-cognitive factors modulating speech intelligibility with a CI, this electroencephalography study examined the central-auditory processing of words, the cognitive abilities, and the speech intelligibility in 10 postlingually single-sided deaf CI users. We found lower hit rates and prolonged response times for word classification during an oddball task for the CI ear when compared with the NH ear. Also, event-related potentials reflecting sensory (N1) and higher-order processing (N2/N4) were prolonged for word classification (targets versus nontargets) with the CI ear compared with the NH ear. Our results suggest that speech processing via the CI ear and the NH ear differs both at sensory (N1) and cognitive (N2/N4) processing stages, thereby affecting the behavioral performance for speech discrimination. These results provide objective evidence for cognition to be a key factor for speech perception under adverse listening conditions, such as the degraded speech signal provided from the CI.

1.
Akeroyd MA: Are individual differences in speech reception related to individual differences in cognitive ability? A survey of twenty experimental studies with normal and hearing-impaired adults. Int J Audiol 2008;47:53-71.
2.
Andersson U: Deterioration of the phonological processing skills in adults with an acquired severe hearing loss. Eur J Cogn Psychol 2002;14:335-352.
3.
Arndt S, Aschendorff A, Laszig R, Beck R, Schild C, Kroeger S, et al: Comparison of pseudobinaural hearing to real binaural hearing rehabilitation after cochlear implantation in patients with unilateral deafness and tinnitus: Otol Neurotol 2011a;32:39-47.
4.
Arndt S, Laszig R, Aschendorff A, Beck R, Schild C, Hassepass F, et al: Einseitige Taubheit und Cochlear-Implant-Versorgung. HNO 2011b; 59:437-446.
5.
Arts RAGJ, George ELJ, Stokroos RJ, Vermeire K: Review: cochlear implants as a treatment of tinnitus in single-sided deafness. Curr Opin Otolaryngol Head Neck Surg 2012;20:398-403.
6.
Aschenbrenner S, Tucha T, Lange KW: Regensburger Wortflüssigkeits-Test: RWT. Göttingen, Hogrefe, 2000.
7.
Banks B, Gowen E, Munro KJ, Adank P: Cognitive predictors of perceptual adaptation to accented speech. J Acoust Soc Am 2015;137:2015-2024.
8.
Bell AJ, Sejnowski TJ: An information-maximization approach to blind separation and blind deconvolution. Neural Comput 1995;7:1129-1159.
9.
Benard MR, Mensink JS, Başkent D: Individual differences in top-down restoration of interrupted speech: links to linguistic and cognitive abilities. J Acoust Soc Am 2014;135:EL88-EL94.
10.
Beynon AJ, Snik AFM, Stegeman DF, van den Broek P: Discrimination of speech sound contrasts determined with behavioral tests and event-related potentials in cochlear implant recipients. J Am Acad Audiol 2005;16:42-53.
11.
Brink D, Hagoort P: The influence of semantic and syntactic context constraints on lexical selection and integration in spoken-word comprehension as revealed by ERPs. J Cogn Neurosci 2004;16:1068-1084.
12.
Buechner A, Brendel M, Lesinski-Schiedat A, Wenzel G, Frohne-Buechner C, Jaeger B, et al: Cochlear implantation in unilateral deaf subjects associated with ipsilateral tinnitus. Otol Neurotol 2010;31:1381-1385.
13.
Classon E, Rudner M, Rönnberg J: Working memory compensates for hearing related phonological processing deficit. J Commun Disord 2013;46:17-29.
14.
Deacon D, Breton F, Ritter W, Vaughan HG: The relationship between N2 and N400: scalp distribution, stimulus probability, and task relevance. Psychophysiology 1991;28:185-200.
15.
Debener S, Hine J, Bleeck S, Eyles J: Source localization of auditory evoked potentials after cochlear implantation. Psychophysiology 2008;45:20-24.
16.
De Heyning PV, Vermeire K, Diebl M, Nopp P, Anderson I, Ridder DD: Incapacitating unilateral tinnitus in single-sided deafness treated by cochlear implantation. Ann Otol Rhinol Laryngol 2008;117:645-652.
17.
Delorme A, Makeig S: EEGLAB: an open source toolbox for analysis of single-trial EEG dynamics including independent component analysis. J Neurosci Methods 2004;134:9-21.
18.
Deutsche Gesellschaft für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie e.V.: Leitlinie der Deutschen Gesellschaft für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie e.V., Bonn: Cochlea-Implantat-Versorgung einschliesslich zentral-auditorischer Implantate. 2012. http://www.awmf.org/leitlinien/detail/ll/017-071.html (accessed January 28, 2016).
19.
Drennan WR, Rubinstein JT: Music perception in cochlear implant users and its relationship with psychophysical capabilities. J Rehabil Res Dev 2008;45:779-789.
20.
Féry C: German word stress in optimality theory. J Comp Ger Linguist 1998;2:101-142.
21.
Finke M, Büchner A, Ruigendijk E, Meyer M, Sandmann P: On the relationship between auditory cognition and speech intelligibility in cochlear implant users: an ERP study. Neuropsychologia 2016;87:169-181.
22.
Finke M, Sandmann P, Kopp B, Lenarz T, Büchner A: Auditory distraction transmitted by a cochlear implant alters allocation of attentional resources. Audit Cogn Neurosci 2015;9:68.
23.
Firszt JB, Holden LK, Reeder RM, Cowdrey L, King S: Cochlear implantation in adults with asymmetric hearing loss. Ear Hear 2012a;33:521-533.
24.
Firszt JB, Holden LK, Reeder RM, Waltzman SB, Arndt S: Auditory abilities after cochlear implantation in adults with unilateral deafness: a pilot study. Otol Neurotol 2012b;33:1339-1346.
25.
Friesen LM, Shannon RV, Başkent D, Wang X: Speech recognition in noise as a function of the number of spectral channels: comparison of acoustic hearing and cochlear implants. J Acoust Soc Am 2001;110:1150-1163.
26.
Friesen LM, Tremblay KL, Rohila N, Wright RA, Shannon RV, Başkent D, et al: Evoked cortical activity and speech recognition as a function of the number of simulated cochlear implant channels. Clin Neurophysiol 2009;120:776-782.
27.
Giraud A-L, Lee H-J: Predicting cochlear implant outcome from brain organisation in the deaf. Restor Neurol Neurosci 2007;25:381-390.
28.
Giraud AL, Truy E, Frackowiak R: Imaging plasticity in cochlear implant patients. Audiol Neurootol 2001;6:381-393.
29.
Gordon KA, Wong DDE, Papsin BC: Bilateral input protects the cortex from unilaterally driven reorganization in children who are deaf. Brain 2013;136:1609-1625.
30.
Groenen PAP, Beynon AJ, Snik AFM, van den Broek P: Speech-evoked cortical potentials recognition in cochlear implant users and speech. 2009. http://informahealthcare.com/doi/abs/10.1080/010503901750069554 (accessed October 2, 2013).
31.
Härkönen K, Kivekäs I, Rautiainen M, Kotti V, Sivonen V, Vasama J-P: Single-sided deafness: the effect of cochlear implantation on quality of life, quality of hearing, and working performance. ORL 2015;77:339-345.
32.
Henkin Y, Tetin-Schneider S, Hildesheimer M, Kishon-Rabin L: Cortical neural activity underlying speech perception in postlingual adult cochlear implant recipients. Audiol Neurotol 2009;14:39-53.
33.
Henkin Y, Yaar-Soffer Y, Steinberg M, Muchnik C: Neural correlates of auditory-cognitive processing in older adult cochlear implant recipients. Audiol Neurotol 2014;19:21-26.
34.
Igelmund P, Meister H, Brockhaus-Dumke A, Fürstenberg D, von Wedel H, Walger M: P300 und Reaktionszeit als Mass für die Höranstrengung von CI-Trägern bei der Lautdiskrimination im Störschall. Ber 12. Jahrestag Dtsch Ges Audiol, Innsbruck, 2009.
35.
Jung T-P, Makeig S, Humphries C, Lee T-W, McKEown MJ, Iragui V, et al: Removing electroencephalographic artifacts by blind source separation. Psychophysiology 2000a;37:163-178.
36.
Jung T-P, Makeig S, Westerfield M, Townsend J, Courchesne E, Sejnowski TJ: Removal of eye activity artifacts from visual event-related potentials in normal and clinical subjects. Clin Neurophysiol 2000b;111:1745-1758.
37.
Kamal SM, Robinson AD, Diaz RC: Cochlear implantation in single-sided deafness for enhancement of sound localization and speech perception. Curr Opin Otolaryngol Head Neck Surg 2012;20:393-397.
38.
Kleine Punte A, De Ridder D, Van de Heyning P: On the necessity of full length electrical cochlear stimulation to suppress severe tinnitus in single-sided deafness. Hear Res 2013;295:24-29.
39.
Kral A, Hubka P, Heid S, Tillein J: Single-sided deafness leads to unilateral aural preference within an early sensitive period. Brain 2013;136:180-193.
40.
Kral A, Kronenberger WG, Pisoni DB, O'Donoghue GM: Neurocognitive factors in sensory restoration of early deafness: a connectome model. Lancet Neurol 2016;15:610-621.
41.
Kral A, Sharma A: Developmental neuroplasticity after cochlear implantation. Trends Neurosci 2012;35:111-122.
42.
Kronenberger WG, Pisoni DB, Harris MS, Hoen HM, Xu H, Miyamoto RT: Profiles of verbal working memory growth predict speech and language development in children with cochlear implants. J Speech Lang Hear Res 2013a;56:805-825.
43.
Kronenberger WG, Pisoni DB, Henning SC, Colson BG: Executive functioning skills in long-term users of cochlear implants: a case control study. J Pediatr Psychol 2013b;38:902-914.
44.
Lazard DS, Lee HJ, Gaebler M, Kell CA, Truy E, Giraud AL: Phonological processing in post-lingual deafness and cochlear implant outcome. Neuroimage 2010;49:3443-3451.
45.
Lehrl S: Mehrfachwahl-Wortschatz-Intelligenztest MWT-B, ed 4, rev. Balingen, Spitta, 1999.
46.
Luck SJ: An Introduction to the Event-Related Potential Technique. Cambridge, MIT Press, 2014.
47.
Lunner T: Cognitive function in relation to hearing aid use. Int J Audiol 2003;42(suppl 1):S49-S58.
48.
Lyxell B, Andersson J, Andersson U, Arlinger S, Bredberg G, Harder H: Phonological representation and speech understanding with cochlear implants in deafened adults. Scand J Psychol 1998;39:175-179.
49.
Lyxell B, Andersson J, Arlinger S, Bredberg G, Harder H, Rönnberg J: Verbal information-processing capabilities and cochlear implants: implications for preoperative predictors of speech understanding. J Deaf Stud Deaf Educ 1996;1:190-201.
50.
Mertens G, De Bodt M, Van de Heyning P: Cochlear implantation as a long-term treatment for ipsilateral incapacitating tinnitus in subjects with unilateral hearing loss up to 10 years. Hear Res 2016a;331:1-6.
51.
Mertens G, Desmet J, De Bodt M, Van de Heyning P: Prospective case-controlled sound localisation study after cochlear implantation in adults with single-sided deafness and ipsilateral tinnitus. Clin Otolaryngol 2016b;41:511-518.
52.
Meyer M, Elmer S, Ringli M, Oechslin MS, Baumann S, Jancke L: Long-term exposure to music enhances the sensitivity of the auditory system in children. Eur J Neurosci 2011;34:755-765.
53.
Nadol J, Young Y, Glynn R: Survival of spiral ganglion cells in profound sensorineural hearing loss: implications for cochlear implantation. Ann Otol Rhinol Laryngol 1989;98:411-416.
54.
Newman R, Chatterjee M: Toddlers' recognition of noise-vocoded speech. J Acoust Soc Am 2013;133:483-494.
55.
Oates PA, Kurtzberg D, Stapells DR: Effects of sensorineural hearing loss on cortical event-related potential and behavioral measures of speech-sound processing. Ear Hear 2002;23:399-415.
56.
Obleser J, Kotz SA: Multiple brain signatures of integration in the comprehension of degraded speech. Neuroimage 2011;55:713-723.
57.
Perrin F, Pernier J, Bertrand O, Echallier JF: Spherical splines for scalp potential and current density mapping. Electroencephalogr Clin Neurophysiol 1989;72:184-187.
58.
Petermann M, Kummer P, Burger M, Lohscheller J, Eysholdt U, Döllinger M: Statistical detection and analysis of mismatch negativity derived by a multi-deviant design from normal hearing children. Hear Res 2009;247:128-136.
59.
Peterson NR, Pisoni DB, Miyamoto RT: Cochlear implants and spoken language processing abilities: review and assessment of the literature. Restor Neurol Neurosci 2010;28:237-250.
60.
Pisoni DB: Cognitive factors and cochlear implants: some thoughts on perception, learning, and memory in speech perception. Ear Hear 2000;21:70-78.
61.
Pisoni D, Kronenberger W, Roman A, Geers A: Measures of digit span and verbal rehearsal speed in deaf children following more than 10 years of cochlear implantation. Ear Hear 2011;32:60s-74s.
62.
Polich J: Semantic categorization and event-related potentials. Brain Lang 1985;26:304-321.
63.
Polich J: Updating P300: an integrative theory of P3a and P3b. Clin Neurophysiol 2007;118:2128-2148.
64.
Punte AK, Vermeire K, Hofkens A, De Bodt M, De Ridder D, Van de Heyning P: Cochlear implantation as a durable tinnitus treatment in single-sided deafness. Cochlear Implants Int 2011;12:S26-S29.
65.
Rönnberg J, Lunner T, Zekveld A, Sörqvist P, Danielsson H, Lyxell B, et al: The Ease of Language Understanding (ELU) model: theoretical, empirical, and clinical advances. Front Syst Neurosci 2013;7:31.
66.
Rönnberg J, Rudner M, Foo C, Lunner T: Cognition counts: a working memory system for Ease of Language Understanding (ELU). Int J Audiol 2008;47:S99-S105.
67.
Rouger J, Lagleyre S, Fraysse B, Deneve S, Deguine O, Barone P: Evidence that cochlear-implanted deaf patients are better multisensory integrators. Proc Natl Acad Sci USA 2007;104:7295-7300.
68.
Rudner M, Foo C, Sundewall-Thorén E, Lunner T, Rönnberg J: Phonological mismatch and explicit cognitive processing in a sample of 102 hearing-aid users. Int J Audiol 2008;47:S91-S98.
69.
Rufener KS, Liem F, Meyer M: Age-related differences in auditory evoked potentials as a function of task modulation during speech-nonspeech processing. Brain Behav 2014;4:21-28.
70.
Sandmann P, Dillier N, Eichele T, Meyer M, Kegel A, Pascual-Marqui RD, et al: Visual activation of auditory cortex reflects maladaptive plasticity in cochlear implant users. Brain 2012;135:555-568.
71.
Sandmann P, Eichele T, Buechler M, Debener S, Jäncke L, Dillier N, et al: Evaluation of evoked potentials to dyadic tones after cochlear implantation. Brain 2009;132:1967-1979.
72.
Sandmann P, Kegel A, Eichele T, Dillier N, Lai W, Bendixen A, et al: Neurophysiological evidence of impaired musical sound perception in cochlear-implant users. Clin Neurophysiol 2010;121:2070-2082.
73.
Sandmann P, Plotz K, Hauthal N, de Vos M, Schönfeld R, Debener S: Rapid bilateral improvement in auditory cortex activity in postlingually deafened adults following cochlear implantation. Clin Neurophysiol 2015;126:594-607.
74.
Schatzer R, Vermeire K, Visser D, Krenmayr A, Kals M, Voormolen M, et al: Electric-acoustic pitch comparisons in single-sided-deaf cochlear implant users: frequency-place functions and rate pitch. Hear Res 2014;309:26-35.
75.
Schmitt BM, Rodriguez-Fornells A, Kutas M, Münte TF: Electrophysiological estimates of semantic and syntactic information access during tacit picture naming and listening to words. Neurosci Res 2001;41:293-298.
76.
Sharma A, Glick H, Campbell J, Torres J, Dorman M, Zeitler DM: Cortical plasticity and reorganization in pediatric single-sided deafness pre- and postcochlear implantation: a case study. Otol Neurotol 2016;37:e26-e34.
77.
Song J-J, Punte AK, De Ridder D, Vanneste S, Van de Heyning P: Neural substrates predicting improvement of tinnitus after cochlear implantation in patients with single-sided deafness. Hear Res 2013;299:1-9.
78.
Sörqvist P, Ljungberg JK, Ljung R: A sub-process view of working memory capacity: evidence from effects of speech on prose memory. Memory 2010;18:310-326.
79.
Tillein J, Hubka P, Kral A: Monaural congenital deafness affects aural dominance and degrades binaural processing. Cereb Cortex 2016;26:1762-1777.
80.
Van den Brink D, Brown C, Hagoort P: Electrophysiological evidence for early contextual influences during spoken-word recognition: N200 versus N400 effects. J Cogn Neurosci 2001;13:967-985.
81.
Vermeire K, Nobbe A, Schleich P, Nopp P, Voormolen MH, Van de Heyning PH: Neural tonotopy in cochlear implants: an evaluation in unilateral cochlear implant patients with unilateral deafness and tinnitus. Hear Res 2008;245:98-106.
82.
Viola FC, Thorne JD, Bleeck S, Eyles J, Debener S: Uncovering auditory evoked potentials from cochlear implant users with independent component analysis. Psychophysiology 2011;48:1470-1480.
83.
Vlastarakos PV, Nazos K, Tavoulari E-F, Nikolopoulos TP: Cochlear implantation for single-sided deafness: the outcomes. An evidence-based approach. Eur Arch Otorhinolaryngol 2013;271:2119-2126.
84.
Wiese R: The Phonology of German. Oxford, Oxford University Press, 2000.
85.
Zekveld AA, Deijen JB, Goverts ST, Kramer SE: The relationship between nonverbal cognitive functions and hearing loss. J Speech Lang Hear Res 2007a;50:74-82.
86.
Zekveld AA, George ELJ, Kramer SE, Goverts ST, Houtgast T: The development of the Text Reception Threshold Test: a visual analogue of the Speech Reception Threshold Test. J Speech Lang Hear Res 2007b;50:576-584.
87.
Zekveld AA, Kramer SE, Festen JM: Pupil response as an indication of effortful listening: the influence of sentence intelligibility: Ear Hear 2010;31:480-490.
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.