Event-related potentials in pediatric cochlear implant patients

Objective: The main objective of this study was to assess the correlation of auditory event related potential (ERP) measures with behavioral assessment data to identify if ERPs including mismatch negativity (MMN) can be used to categorize cochlear implant patients into good and poor performers. Design: We investigated auditory event-related potentials to standard and deviant speech stimuli presented in a pseudorandom sequence in 35 cochlear implant patients between the ages of 7 and 17 yr. We compared the occurrence, latencies, and amplitudes of P1, N2, and MMN with overall behavioral outcome in these children. Behavioral measures included category of auditory performance scores and speech intelligibility rating scores. Results: Auditory ERPs in response to standard stimuli were identifiable in 30 of 35 patients, demonstrating a major positive component (P1) followed by a negativity (N2) with absence of N1 in all patients. The P1 component in prelingually deaf patients showed a statistically significant reduction in its latency with increasing duration of implant use. MMN was recorded in 80-85% of star performers but in only 15-20% of poor performers. Patients with higher SIR scores demonstrated statistically significant longer duration of MMN compared with those with a lower SIR score. Conclusions: These results indicate that MAIN can be used to assess the functional status of the auditory cortex in terms of auditory memory and discrimination in young children with cochlear implants and may provide an objective mechanism for differentiating good from poor performers.