Pre-implant resting-state connectivity links to post-cochlear implantation auditory/language outcomes in children...

To investigate whether preoperative resting-state functional connectivity (rs-FC) patterns can predict auditory and language rehabilitation outcomes following cochlear implantation (CI) in children with severe-to-profound congenital sensorineural hearing loss (CSHL), thereby informing individualized prognostic and therapeutic strategies.

Twenty pediatric patients with bilateral CSHL underwent resting-state functional magnetic resonance imaging (rs-fMRI) prior to CI during the sensitive period of auditory cortex development. The Infant-Toddler Meaningful Auditory Integration Scale/Meaningful Auditory Integration Scale (IT-MAIS/MAIS) was used to assess the postoperative auditory and language abilities at five time points over 12 months. Multiple linear regression analyses were performed to evaluate the relationship between pre-CI rs-FC and behavioral outcomes. A predictive model was developed based on significant rs-FC features.

Significant improvements in the IT-MAIS/MAIS scores were observed at each follow-up point post-implantation (p < 0.0001). Preoperative rs-FC, involving the prefrontal cortex, occipitoparietal regions, and subcortical structures, strongly correlated with baseline and longitudinal auditory performance. FCs between specific brain regions, including the orbital frontal cortex, angular gyrus, and Heschl's gyrus, were associated with different phases of postoperative improvement. The rs-FC-based predictive model demonstrated high explanatory power for post-CI outcomes (R² values up to 0.82).

Resting-state brain connectivity patterns pre-CI can serve as reliable neuroimaging biomarkers for predicting auditory and language rehabilitation outcomes in young children with CSHL. These findings provide a neurofunctional basis for early prognostication and support the development of personalized rehabilitation protocols guided by preoperative brain imaging.