Asymmetric Inter-Hemisphere Communication Contributes to Speech Acquisition of Toddlers with Cochlear Implants

How the lateralized language network and its functions emerge with early auditory experiences remains largely unknown. Here, early auditory development is examined using repeated optical imaging for cochlear implanted (CI) toddlers with congenital deafness from onset of restored hearing to around one year of CI hearing experiences. Machine learning models are constructed to resolve how functional organization of the bilateral language network and its sound processing support the CI children's post-implantation development of auditory and verbal communication skills. Behavioral improvement is predictable by cortical processing as well as by network organization changes, with the highest classification accuracy of 81.57%. For cortical processing, behavioral prediction is better for the left than the right hemisphere and for speech than non-speech processing. For network organization, the best prediction is obtained for resting state, with greater contribution from inter-hemisphere connections between non-homologous regions than from within-hemisphere connections. Most interestingly, systematic connectivity-to-activity models reveal that speech processing of the left language network is developmentally supported largely by global network organization, particularly asymmetric inter-hemisphere communication, rather than functional segregation of local network. These findings collectively confirm the importance of asymmetric inter-hemisphere communication in formation of the lateralized language network and its functional development with early auditory experiences.