Alterations in cortical 40-Hz auditory steady-state response dynamics in children with mild-to-severe hearing loss are related to hearing aid use

Children who are hard-of-hearing (CHH) show greater variability in language and academic outcomes than children with normal hearing (CNH) throughout development, despite early detection and intervention. Nonetheless, our understanding of the neural mechanisms underlying sensory and cognitive processing in CHH remains incomplete. The 40-Hz cortical auditory steady-state response (ASSR) has been widely used as a marker of auditory system integrity and shown to relate to cognition. Thus, the current study sought to determine the impact of mild-to-severe hearing loss on cortical ASSR dynamics. Thirty-seven participants ages 7-15 years old heard a broadband click train stimulus presented at 40 Hz binaurally during magnetoencephalography (MEG). Peak sources in the bilateral primary auditory cortices were identified, and the power envelope of the 40 Hz ASSR was extracted as a function of time and submitted to linear mixed modeling. We found a significant three-way interaction, suggesting that CHH exhibit altered ASSR dynamics between hemispheres compared to CNH. Moreover, hearing aid use was significantly correlated with left hemisphere ASSR power in CHH. These data underscore the importance of consistent auditory access in CHH and provide preliminary evidence that neuroimaging may hold promise in determining the mechanisms underlying behavioral variability in this population.