The central auditory system and auditory deprivation: experience with cochlear implants in the congenitally deaf

In the present paper we briefly review the response of the central auditory system to auditory deprivation and describe recent experimental and clinical experience with cochlear implants. While the central auditory system undergoes marked changes in response to auditory deprivation, it would appear that at least a rudimentary cochleotopic organisation is maintained at the level of the brainstem and auditory cortex in animals deafened from birth. Moreover, recent studies have demonstrated the ability of the central auditory system to undergo functional reorganisation in response to changes in the pattern of afferent activity. Clinical experience has shown that deaf children with little or no prior auditory experience can obtain significant benefit from cochlear implants, provided the device is fitted at a young age. Furthermore, factors predicting successful clinical outcomes with these devices reflect the importance of auditory experience, either prior to an acquired loss or with the use of a cochlear implant. These findings suggest that functional reorganisation within the central auditory pathway can at least partially account for improvements in clinical performance over time.