Cognitive Functions in Adults Receiving Cochlear Implants: Predictors of Speech Recognition and Changes After Implantation.

Abstract

Significant variability in speech recognition outcomes is consistently observed in adults who receive cochlear implants (CIs), some of which may be attributable to cognitive functions. Two hypotheses were tested: 1) preoperative cognitive skills assessed visually would predict postoperative speech recognition at 6 months after CI; and 2) cochlear implantation would result in benefits to cognitive processes at 6 months. Several executive functioning tasks have been identified as contributors to speech recognition in adults with hearing loss. There is also mounting evidence that cochlear implantation can improve cognitive functioning. This study examined whether preoperative cognitive functions would predict speech recognition after implantation, and whether cognitive skills would improve as a result of CI intervention. Nineteen post-lingually deafened adult CI candidates were tested preoperatively using a visual battery of tests to assess working memory (WM), processing speed, inhibition-concentration, and nonverbal reasoning. Six months post-implantation, participants were assessed with a battery of word and sentence recognition measures and cognitive tests were repeated. Multiple speech measures after 6 months of CI use were correlated with preoperative visual WM (symbol span task) and inhibition ability (stroop incongruent task) with moderate-to-large effect sizes. Small-to-large effect size improvements in visual WM, concentration, and inhibition tasks were found from pre- to post-CI. Patients with lower baseline cognitive abilities improved the most after implantation. Findings provide evidence that preoperative cognitive factors contribute to speech recognition outcomes for adult CI users, and support the premise that implantation may lead to improvements in some cognitive domains.