title: Cortical development, plasticity and re-organization in children with cochlear implants.
abstract: A basic tenet of developmental neurobiology is that certain areas of the cortex will re-organize, if appropriate stimulation is withheld for long periods. Stimulation must be delivered to a sensory system within a narrow window of time (a sensitive period) if that system is to develop normally. In this article, we will describe age cut-offs for a sensitive period for central auditory development in children who receive cochlear implants. We will review de-coupling and re-organization of cortical areas, which are presumed to underlie the end of the sensitive period in congenitally deaf humans and cats. Finally, we present two clinical cases which demonstrate the use of the P1 cortical auditory evoked potential as a biomarker for central auditory system development and re-organization in congenitally deaf children fitted with cochlear implants.
  
  
  OBJECTIVE
  Readers of this article should be able to (i) describe the importance of the sensitive period as it relates to development of central auditory pathways in children with cochlear implants; (ii) discuss the hypothesis of de-coupling of primary from higher-order auditory cortex as it relates to the end of the sensitive period; (iii) discuss cross-modal re-organization which may occur after long periods of auditory deprivation; and (iv) understand the use of the P1 response as a biomarker for development of central auditory pathways.
authors.affiliation: Brain and Behavior Laboratory, Department of Speech, Language and Hearing Sciences, University of Colorado at Boulder, 2501 Kittredge Loop Road, 409 UCB, Boulder, CO 80309-0409, USA. anu.sharma@colorado.edu
authors.forename: Anu
authors.initials: A
authors.lastname: Sharma
authors.forename: Amy A
authors.initials: AA
authors.lastname: Nash
authors.forename: Michael
authors.initials: M
authors.lastname: Dorman
mesh_terms: D000161:Acoustic Stimulation; D000375:Aging / Q000502:physiology*; D000818:Animals; D001303:Auditory Cortex / Q000254:growth & development / Q000502:physiology; D001306:Auditory Pathways / Q000254:growth & development / Q000502:physiology; D015415:Biomarkers; D001921:Brain / Q000254:growth & development* / Q000502:physiology*; D002415:Cats; D002648:Child; D003054:Cochlear Implants; D003423:Critical Period, Psychological; D005072:Evoked Potentials, Auditory; D005260:Female; D006801:Humans; D008297:Male; D009473:Neuronal Plasticity; D012683:Sensory Deprivation / Q000502:physiology
chemical_list: D015415:Biomarkers