Neural markers of attention processing in pediatric cochlear implant users: an ERP study

The current study examined the neural mechanisms underlying auditory outcomes in pediatric cochlear implant (CI) users using event-related potentials, focusing on the frontocentral Novelty P3 (indexing automatic attention) and the parietal Target P3 (reflecting controlled attention). By comparing CI children with normal-hearing peers, we aimed to elucidate how these attention mechanisms contribute to post-implantation auditory performance variability. Prelingually deaf children with early bilateral CIs (n = 25) and normal-hearing (NH) controls (n = 28), matched for gender and age (7-13 years), completed an oddball paradigm during ERP recording and performed speech-in-noise and memory tasks. CI users showed reduced Novelty P3 amplitudes compared to NH peers, suggesting impaired automatic attention mechanisms, while Target P3 amplitudes were comparable between groups, indicating preserved controlled attention. CI users demonstrated poorer performance on speech-in-noise recognition and forward digit span tasks. Larger Novelty P3 and Target P3 amplitudes both correlated positively with speech-in-noise performance across all participants. In contrast, in CI users specifically, Target P3 amplitudes showed positive associations with short-term memory performance. This study provides novel evidence that pediatric CI users exhibit reduced automatic attention shifting in response to acoustic changes while maintaining intact controlled attention processes that may serve as a compensatory mechanism. The neural markers' associations with behavioral performance suggest potential intervention targets: rehabilitation efforts might focus on strengthening automatic attention shifting while leveraging preserved controlled attention pathways.