Chronic acoustic degradation via cochlear implants alters predictive processing of audiovisual speech

This study provides the first neurophysiological evidence of how cochlear implant (CI) input affects predictive processing during audiovisual language comprehension in deaf individuals. Using EEG, we compared 18 CI users with 18 normal-hearing (NH) controls during sentence comprehension where final word predictability was determined by high or low semantic constraint (HC vs. LC) of the preceding sentence frame. Between sentence frame and final word, a 800 ms silent gap was introduced. Mouth visibility was manipulated during sentence frames (visible or digitally occluded; V+ vs. V-), while the final words were always presented with the mouth visible. In NH participants, lower-beta power (12-15 Hz) in left frontal and central sensors decreased for HC vs. LC contexts during the pre-target silent gap, but only when the mouths was visible, suggesting active prediction generation. In CI users, this lower beta power decrease was absent. After final word presentation, both groups showed N400 predictability effects, indicating preserved prediction evaluation. However, CI users exhibited extended N400 effects in the V+ condition, suggesting additional processing demands. Across all participants, pre-target beta modulations correlated with language production abilities, supporting prediction-by-production frameworks. Within CI users, poorer audiometric thresholds correlated with larger N400 constraint effects, possibly indicating greater reliance on contextual prediction to compensate for degraded sensory input. These findings demonstrate that CI-mediated perception alters the neural mechanisms of prediction generation. The link between production skills and predictive mechanisms suggests that strengthening expressive language abilities may enhance predictive processing in CI users.