Cochlear implantation in children with congenital cytomegalovirus infection accompanied by psycho-neurological disorders

Abstract

Conclusion: Cochlear implantation was effective for deaf children with congenital cytomegalovirus (CMV) infection, but their cochlear implant (CI) outcomes were often impaired, depending on the types of CMV-associated psycho-neurological disorders. Evaluation of cognitive development and autistic tendency of implantees might be useful to predict their CI outcomes. Objectives: To reveal the influence of CMV-associated psycho-neurological disorders on CI outcomes. Methods: This was a retrospective evaluation of 11 implantees with congenital CMV infection (CMV-CIs) and 14 implantees with autosomal recessive hearing loss (genetic-CIs). Results: Nine of 11 CMV-CIs suffered from psycho-neurological disorders; one from attention deficit hyperactivity disorder, two from pervasive developmental disorder, and six from mental retardation. Aided hearing thresholds with CIs in the two groups did not differ, but two autistic and two mentally retarded CMV-CIs showed significantly low scores in speech discrimination tests. Language-Social (L-S) developmental quotients (DQs) evaluated by the Kyoto Scale of Psychological development were improved after the implantation in both groups, but the postoperative increase of L-S DQs was significantly smaller in the CMV-CIs than that of genetic-CIs. Interestingly, the postoperative L-S and Cognitive-Adaptive (C-A) DQs showed statistically significant correlation in all cases except for two autistic CMV-CIs whose L-S DQs were much lower than those expected from their C-A DQs.

Keywords::

• Cochlear implant
• pervasive developmental disorder
• PDD
• autistic
• language development
• cognitive development

Acknowledgments

We thank Dr Masahiro Nakayama at Osaka Medical Center and Research Institute for Maternal and Child Health for performing the PCR-based diagnosis of congenital CMV infection using dried umbilical cords. Dr Mieko Yoshioka at Department of Pediatric Neurology Kobe City Pediatric and General Rehabilitation Center for the Challenged gave insightful comments and suggestions about congenital CMV infection. This study was supported by a Grant-in-Aid for scientific research (C): 22591894 and Grant-in-Aid for Young Scientists (B): 22791642 from the Japanese Ministry of Education, Culture, Sports, Science and Technology.

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.