Age at implantation is considered to be a major factor, influencing outcomes after pediatric cochlear implantation. In the absence of acoustic input, it has been proposed that cross-modal reorganization can be detrimental for adaptation to the new electrical input provided by a cochlear implant. Here, through a retrospective study, we aimed to investigate differences in cerebral blood flow (CBF) at rest prior to implantation in children with congenital deafness compared to normally hearing children. In addition, we looked at the putative link between pre-operative rest-CBF and the oral intelligibility scores at 12 months post-implantation. Finally, we observed the evolution of perfusion with age, within brain areas showing abnormal rest-CBF associated to deafness, in deaf children and in normally hearing children. In children older than 5 years old, results showed a significant bilateral hypoperfusion in temporal regions in deaf children, particularly in Heschl’s gyrus, and a significant hyperperfusion of occipital regions. Furthermore, in children older than 5 years old, whole brain voxel-by-voxel correlation analysis between pre-operative rest-CBF and oral intelligibility scores at 12 months post-implantation, showed significant negative correlation localized in the occipital regions: children who performed worse in the speech perception test one year after implantation were those presenting higher preoperative CBF values in these occipital regions. Finally, when comparing mean relative perfusion (extracted from the temporal regions found abnormal on whole-brain voxel-based analysis) across ages in patients and controls, we observed that the temporal perfusion evolution was significantly different in deaf children than in normally hearing children. Indeed, while temporal perfusion increased with age in normally hearing children, it remained stable in deaf children. We showed a critical period around 4 years old, where in the context of auditory deprivation, there is a lack of synaptic activity in auditory regions. These results support the benefits of early cochlear implantation to maximize the effectiveness of auditory rehabilitation and to avoid cross-modal reorganization.

植入年龄被认为是影响儿科人工耳蜗植入后结果的主要因素。在没有声学输入的情况下，有人提出，跨模式重组可能不利于适应人工耳蜗提供的新电输入。在此，通过一项回顾性研究，我们旨在调查先天性耳聋儿童与正常听力儿童在植入前静息时脑血流量 (CBF) 的差异。此外，我们还研究了术前休息 CBF 与植入后 12 个月的口腔清晰度评分之间的假定联系。最后，我们观察了聋哑儿童和听力正常儿童中与耳聋相关的异常静息 CBF 的大脑区域内灌注随年龄的变化。在 5 岁以上的儿童中，结果显示聋哑儿童的颞部区域存在显着的双侧灌注不足，特别是赫施尔回，枕骨区域存在显着的过度灌注。此外，在 5 岁以上的儿童中，术前休息 CBF 与植入后 12 个月的口腔清晰度评分之间的全脑逐体素相关性分析显示，枕骨区域存在显着负相关：植入一年后言语感知测试中表现更差的是那些在这些枕骨区域术前 CBF 值较高的患者。最后，当比较不同年龄的患者和对照组的平均相对灌注（从基于全脑体素分析发现异常的颞区提取）时，我们观察到聋哑儿童的时间灌注演变与正常听力儿童显着不同。 事实上，虽然正常听力儿童的颞部灌注随着年龄的增长而增加，但聋哑儿童的颞部灌注保持稳定。我们展示了 4 岁左右的关键时期，在听觉剥夺的情况下，听觉区域缺乏突触活动。这些结果支持早期人工耳蜗植入的好处，可以最大限度地提高听觉康复的有效性并避免跨模式重组。