Original Investigation

Peripheral Neural Plasticity in Cochlear Implant Users Across the Lifespan

JAMA Otolaryngology–Head & Neck Surgery 10.1001/jamaoto.2025.4050

November 20, 2025 at 11:00 AM EST

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Can neural responses measured in cochlear implant users be standardized to monitor auditory nerve health and plasticity over time?In this cohort study analyzing more than 169 000 recordings from more than 10 000 cochlear implants in 7416 patients, auditory nerve activity varied by cochlear location and age at implantation. Children implanted at younger ages showed stronger responses and clear evidence of plasticity, particularly in the first 5 years after activation; these changes were not observed in older users.Model-based analysis of neural recordings provide a scalable method for tracking auditory nerve health across the lifespan and highlight the importance of early implantation for long-term outcomes.

Corresponding Author: Stéphane F. Maison, PhD, Eaton-Peabody Laboratories, Massachusetts Eye stephane_maison@meei.harvard.edu).

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