Learning in a task of complex auditory streaming and identification

Adult humans were studied for improvements in their ability to segregate natural whole speech in background noise, in 6 test sessions spaced with a very wide range of inter-session interval (ISI) ranging from minutes to weeks apart so as to examine the effect of this parameter on initial (early) and late components of perceptual learning. Improvements were found even with spacings of 3 weeks between the punctate task sessions. All subjects showed similar total learning amounts but there were sex- and ISI-dependent differences in learning patterns, which we indexed by dividing the overall exponentially-decreasing learning pattern into an early phase between the first two sessions and a later phase between the second and sixth sessions. Males tested at all ISIs and females tested at short (2, 5 and 15 min) and long (1-21 days) ISIs showed small amounts of early-phase learning and large amounts of late-phase learning. However, females tested at intermediate (30 min and 1h) ISIs showed only early learning, i.e., faster learning given that the total learning was the same. This sex- and ISI-specific deviant pattern could be changed to the standard pattern by interposing an overnight interruption that included sleep amongst test sessions. Thus, improvement in this complex auditory streaming and identification task can occur even with very brief and widely-spaced exposure, generally through a standard pattern of slower overall learning, but also through a sex- and ISI-specific deviant pattern of very rapid early learning which can be modulated by interposed delay unlike the standard pattern.

Heterogeneity in the coding in rat barrel cortex of the velocity of protraction of the macrovibrissae

Rats whisk to explore their environment and obtain information on object features, and the responses of somatosensory cortical neurones must precisely encode aspects of whisker movements. Using trapezoidal stimuli to deflect whiskers, with a wide range of velocities and amplitudes of whisker protraction, we recorded responses from a relatively homogeneous population of isolated cells and neuronal multiunits within the postero-medial barrel sub-field of somatosensory cortex, and analysed responses in an early post-stimulus-onset window. For 92% of neurones the function relating response strength to velocity was a saturating sigmoid but there were differences between neurones in the slopes and ranges over which responses changed. Responses of other neurones were non-monotonic, with response strength decaying at very high whisker deflection velocities. Generally, barrel cortex neurones were responsive to a much wider range of whisker protraction velocities than hitherto reported, especially to much slower velocities than generally assumed to be the main range of sensitivity. This carries implications for coding of whisker deflection velocity, a parameter that appears to be a significant information-bearing element of natural whisking. The effect of amplitude of deflection upon neural responses was evident in only approximately 24% of units and only when the dominant velocity effect had saturated.

Bandwidth dependency of cochlear centrifugal pathways in modulating hearing desensitization caused by loud sound

Centrifugal olivocochlear (OC) pathways modulate cochlear hearing desensitization induced by loud sounds, but there is a null point, determined by sound bandwidth, for this effect. In a previous study, using loud sounds from the region of greatest hearing sensitivity in cats, OC pathways did not affect desensitization induced by 2-kHz wide noise, but did to narrower bandwidth (tones) or broader bandwidth (3.5 kHz-wide or 5 kHz-wide noise) trauma from the same cochlear region. The bandwidth null-point effect occurred in three very different conditions in which OC pathways modulated losses to narrower or broader bandwidth traumata, confirming the robustness of this phenomenon, and was also true for sub-component OC pathways: neither crossed nor uncrossed OC pathways individually modulated desensitization to that 2 kHz-wide noise. The medial olivocochlear system (MOCS) that is most likely to have modulated desensitization in that study, varies in its cochlear distribution; in cats, densest innervation is in the region of greatest hearing sensitivity and the decrease away from that region means MOCS effects there may not translate to other regions. This hypothesis was now tested in lower- (around 4 kHz) and higher- (around 18 kHz) frequency cochlear regions. Across this fairly large cochlear swath, no OC modulation of desensitization occurred to 2-kHz-wide bandwidth sounds, but did to broader bandwidth; thus the bandwidth dependency was constant across this swath. However, when OC effects did occur, the pattern of effects of OC sub-components could be idiosyncratic to sound bandwidth and cochlear region even for similar net OC effects.

Bandwidth determines modulatory effects of centrifugal pathways on cochlear hearing desensitization caused by loud sound

Centrifugal olivocochlear (OC) pathways modulate cochlear hearing losses induced in cats by loud sounds varying in bandwidth from tones to clicks and noise bands, in a variety of conditions. The general effect, always to reduce hearing damage, can be a net effect resulting from complex interactions between OC subcomponents (crossed and uncrossed OC pathways). The interactions between these subcomponents vary with type of loud sound, suggesting that sound bandwidth may be important in determining how OC pathways modulate loud sound-induced hearing loss. This dependency was examined and here it is reported that OC pathways do not alter cochlear hearing losses caused by loud noise with a 2-kHz-wide bandwidth intermediate between the loud sounds of previous studies. Increasing stimulus bandwidth even slightly more, to use a loud 3.5-kHz-wide bandwidth noise as the damaging sound, once again revealed OC modulation of cochlear hearing loss. The fact that OC pathways do not modulate cochlear hearing losses induced by loud 2-kHz-wide noise was demonstrated in three very different test conditions in which OC pathways modulate hearing losses caused by narrower or broader bandwidth sounds. This confirmed that the absence of centrifugal modulation of hearing loss to this particular sound was a robust phenomenon not related to test condition. The absence of overall centrifugal effects was also true at the level of subcomponent pathways; neither crossed nor uncrossed OC pathways individually modulated cochlear hearing losses to the loud 2-kHz-wide noise. This surprising frequency dependency has general implications for centrifugal modulation of cochlear responses.

A novel stimulus system for applying tactile stimuli to the macrovibrissae in electrophysiological experiments

The rat's vibrissae are a wonderful system for the study of sensory neural encoding in relation to behaviour because the vibrissae are easily identifiable and accessible for manipulation, allowing easy application of a variety of different types of deflections that mimic natural whisking. Here we report the development of a powerful and flexible method for precisely deflecting these vibrissae. Recordings from CNS neurons showed, in response to variations in the parameters of a trapezoid whisker deflection stimulus that mimics the basic unit of whisking, a variety of complex responses as well as complex interactions between different response components. The recordings also included a response that is reported to be found during active whisking (movement under muscle control) and not passive whisker movements and thus to differentiate active from passive whisker deflections. Thus, this system could well be used in anaesthetized animals to apply whisker deflections that well mimic natural active whisking in awake animals, thereby allowing highly detailed study of the neuronal responses and neuronal interactions found with natural whisking behaviour.

Contextual modulation of cochlear hearing desensitization depends on the type of loud sound trauma

In ears in which cochlear efferent pathways were cut and with testing done under anaesthetic conditions that preclude middle ear muscle activity (so as to examine the "intrinsic" effects of loud sound on the cochlea without any confounding effect of efferent pathways to the auditory periphery), atraumatic background white noise (WN) increases cochlear hearing loss (temporary threshold shifts, TTSs) induced by a traumatic pure tone but reduces TTSs caused by traumatic 5-kHz wide narrow band (NB) sound. The short-duration moderately intense traumata used in these studies most likely cause TTSs by affecting cochlear mechanics and these WN modulatory effects, exerted directly on the cochlea's intrinsic susceptibility to TTSs, are not predicted by any current description of cochlear mechanics. Here it is demonstrated that background WN reduces trauma-induced TTSs with even a relatively small increase in trauma bandwidth beyond that of a pure tone, discounting the alternative that contextual modulatory effects transition systematically along a continuum as trauma bandwidth increases from a pure tone to a broader bandwidth (albeit 2 kHz-wide NB) trauma. These results have implications for cochlear mechanics as the TTSs due to the traumatic sound of this study are most likely due to changes in cochlear mechanics but are not easily explained by what is currently known of cochlear mechanics.

Colonization of mycoplasma in the upper respiratory tract of AIDS patients with pulmonary symptoms in Chennai, India

BACKGROUND & OBJECTIVE

Mycoplasmas have been implicated in causing minor to severe respiratory infections in man. Mycoplasmas are considered to act as cofactors in patients with AIDS. A preliminary study was conducted to isolate mycoplasmas from sputum specimens of AIDS patients and non-HIV patients with underlying pulmonary symptoms and signs.

METHODS

A total of 130 sputum samples (100 from AIDS patients and 30 from non-HIV) were cultured on standard pleuropneumonia-like organisms (PPLO) glucose agar up to 3 wk. The plates were examined for the presence of fried-egg colonies characteristic of Mycoplasma. Subsequently the plates were stained using Diene's stain. Sputum specimens from the AIDS patients were also screened for other bacterial pathogens.

RESULTS

Mycoplasmas were detected from 36 (36%) of the AIDS patients and only 5 (16.6%) of the non HIV control individuals with underlying pulmonary symptoms. Data on the detection rates of other microorganisms from the AIDS cases were also analysed.

INTERPRETATION & CONCLUSION

This preliminary study provided supportive evidence that mycoplasma colonized in upper respiratory tract of individuals with AIDS to a larger extent than that of the non HIV subjects with pulmonary symptoms. Further studies need to be done to characterize mycoplasma isolates to species level.

Non-Hodgkin's lymphoma in systemic lupus erythematosus

BACKGROUND

Recent evidence supports an association between systemic lupus erythematosus (SLE) and non-Hodgkin's lymphoma (NHL).

OBJECTIVES

To describe demographic factors, subtypes, and survival of patients with SLE who develop NHL.

METHODS

A multi-site cohort of 9547 subjects with definite SLE was assembled. Subjects at each centre were linked to regional tumour registries to determine cancer cases occurring after SLE diagnosis. For the NHL cases ascertained, descriptive statistics were calculated, and NHL subtype frequency and median survival time of patients determined.

RESULTS

42 cases of NHL occurred in the patients with SLE during the 76,948 patient-years of observation. The median age of patients at NHL diagnosis was 57 years. Thirty six (86%) of the 42 patients developing NHL were women, reflecting the female predominance of the cohort. In the patients, aggressive histological subtypes appeared to predominate, with the most commonly identified NHL subtype being diffuse large B cell (11 out of 21 cases for which histological subtype was available). Twenty two of the patients had died a median of 1.2 years after lymphoma diagnosis.

CONCLUSIONS

These data suggest aggressive disease in patients with SLE who develop NHL. Continuing work should provide further insight into the patterns of presentation, prognosis, and aetiology of NHL in SLE.

An international cohort study of cancer in systemic lupus erythematosus

OBJECTIVE

There is increasing evidence in support of an association between systemic lupus erythematosus (SLE) and malignancy, but in earlier studies the association could not be quantified precisely. The present study was undertaken to ascertain the incidence of cancer in SLE patients, compared with that in the general population.

METHODS

We assembled a multisite (23 centers) international cohort of patients diagnosed as having SLE. Patients at each center were linked to regional tumor registries to determine cancer occurrence. Standardized incidence ratios (SIRs) were calculated as the ratio of observed to expected cancers. Cancers expected were determined by multiplying person-years in the cohort by the geographically matched age, sex, and calendar year-specific cancer rates, and summing over all person-years.

RESULTS

The 9,547 patients from 23 centers were observed for a total of 76,948 patient-years, with an average followup of 8 years. Within the observation interval, 431 cancers occurred. The data confirmed an increased risk of cancer among patients with SLE. For all cancers combined, the SIR estimate was 1.15 (95% confidence interval [95% CI] 1.05-1.27), for all hematologic malignancies, it was 2.75 (95% CI 2.13-3.49), and for non-Hodgkin's lymphoma, it was 3.64 (95% CI 2.63-4.93). The data also suggested an increased risk of lung cancer (SIR 1.37; 95% CI 1.05-1.76), and hepatobiliary cancer (SIR 2.60; 95% CI 1.25, 4.78).

CONCLUSION

These results support the notion of an association between SLE and cancer and more precisely define the risk of non-Hodgkin's lymphoma in SLE. It is not yet known whether this association is mediated by genetic factors or exogenous exposures.

Contextual modulation of olivocochlear pathway effects on loud sound-induced cochlear hearing desensitization

This study shows that the cochlear hearing losses [temporary threshold shifts (TTSs)] induced by traumatic sound and the effect of olivocochlear (OC) pathways to the cochlea on these hearing losses depend on the context of the sound. Background atraumatic white noise (WN) has been shown to 1) exacerbate loud-pure-tone-induced TTSs, and 2) promote the modulation of TTSs by the uncrossed OC (UOC) pathways additional to the action on TTSs, elicited by binaural loud tones themselves, by the crossed OC (COC) pathway. Here the same atraumatic WN reduced TTSs caused by loud narrow band sound. It also reduced TTS modulation by OC pathways. The UOC no longer exerted any effects on TTSs, and COC effects were significantly reduced in two discrete frequency bands: low frequencies within the narrow band ("within-band" frequencies) and high frequencies outside the band ("high-side" frequencies). COC effects were unchanged at high frequencies within the band. Despite these reductions in OC effects, because the WN itself reduced TTSs, the total effect of OC pathways and background WN now produced larger TTS reductions, especially at higher frequencies. Thus the modulatory effects of the OC pathways on TTSs depend on how background WN modulates cochlear state. It is postulated that the WN background and the OC pathways both modulate TTSs by acting on the outer hair cells, in a way that promotes the reduction of TTSs caused by the narrow band sound trauma. This joint promotion of a protective end-effect on TTSs to narrow band sound trauma contrasts against the effects seen with pure tone trauma where the same background WN exacerbated TTSs at high-side frequencies.

Factors associated with abnormal Pap results in systemic lupus erythematosus

OBJECTIVE

Previous studies have suggested that women with systemic lupus erythematosus (SLE) are at greater risk for cervical dysplasia than are women in the general population. However, the factors associated with abnormal Pap test results in SLE have not been well studied. We therefore aimed to determine the factors associated with lifetime occurrence of an abnormal Pap test in women with SLE, and the influence of immunosuppressive exposure on the odds of abnormal Pap test results occurring after diagnosis of SLE.

METHODS

Data were pooled from SLE cohorts from three centres. Self-report data were available on smoking, reproductive history, use of oral contraceptives (OC), history of sexually transmitted diseases (STDs) and whether the subjects had had cervical dysplasia on Pap testing. Logistic regression was used to examine the effect of these variables on the lifetime odds of cervical dysplasia. We then generated the adjusted odds ratio (OR) for the effect of immunosuppressive exposure on cervical dysplasia occurring after diagnosis of SLE.

RESULTS

History of STDs and use of OCs were positively associated with reports of cervical dysplasia in adjusted analyses. The ORs for the effect of immunosuppressives on abnormal Pap test occurrence (adjusted for race, age, smoking, nulliparity, OC use and history of STDs) after diagnosis of SLE was 1.6 (95% CI 1.0, 2.7).

CONCLUSIONS

A history of STDs and use of OCs were associated with abnormal Pap reports in this SLE sample. Immunosuppressive exposure may confer further risk to women with SLE.

Hormonal exposures and breast cancer in a sample of women with systemic lupus erythematosus

OBJECTIVES

To determine if breast cancer risk in women with SLE is modified by a history of exposure to hormone replacement therapy (HRT) or oral contraceptives (OC), after adjusting for other risk factors.

METHODS

Data were pooled from SLE cohorts at three centres. For each female cohort member (n = 871), the probability of developing breast cancer was estimated from factors (age, parity, age at first live birth, age of menarche, personal history of benign breast disease, family history) in the Gail model, an established tool for predicting breast cancer risk. From these probabilities, the expected number of breast cancers for the cohort was estimated. Actual occurrence of cases was determined by linkage with regional cancer registries. Standardized incidence ratios (SIRs; ratio of cancers observed to expected) were calculated, with subgroup analyses according to HRT and OC exposure.

RESULTS

In the cohort, 15 breast cancers occurred vs 7.2 predicted [SIR 2.1, 95% confidence interval (CI) 1.1, 3.5]. When controlling for Gail model risk factors, estimates were similar for women never exposed to HRT vs those exposed to HRT. Adjusted SIR estimates appeared similar also for women exposed or not exposed to OC.

CONCLUSIONS

Although not definitive, the data suggest that the breast cancer experience in this sample is not completely explained by factors such as reproductive and family history, or by exogenous hormonal exposures. Other determinants, including medication exposures or genetic factors (possibly related to oestrogen receptors or metabolism) may be important. Variations in these factors might explain why an elevated risk of breast cancer has not been apparent in all SLE populations.

Crossed and uncrossed olivocochlear pathways exacerbate temporary shifts in hearing sensitivity after narrow band sound trauma in normal ears of animals with unilateral hearing impairment

Olivocochlear (OC) pathways have been shown to reduce the temporary threshold shifts (TTSs) caused by traumatic sounds. More recently they have been shown to exacerbate TTSs under certain conditions. One condition is the normal-hearing ear of animals with a chronic unilateral hearing loss. Testing with pure tone trauma showed that then (a) the normal-hearing ear had a lower-than-normal 'intrinsic' susceptibility to intense tones, (b) binaural trauma exacerbated TTSs in the normal-hearing ear through the activity of uncrossed OC (UOC) pathways, and (c) there was no effect on TTSs of the crossed OC (COC) pathway to the normal-hearing ear. The present study is an examination in such animals of effects with noise band trauma. The effects here confirm the previous finding that under such conditions the normal-hearing ear has a lower-than-normal susceptibility to loud sound, and binaural loud sounds exacerbate TTSs in the normal-hearing ear. They extend the previous study by demonstrating that with this traumatic sound, both COC and UOC pathways exacerbate TTSs. These effects contrast against the effects seen in animals with bilaterally normal hearing for the same noise band. Given the commonality of unilateral hearing losses in the normal human population, these data have implications for the functional effects of the OC pathways on loud sound-induced hearing damage.

Performance of power assisted respirators during simulated asbestos removal

Protection factors were measured on full face mask power assisted respirators when worn by experienced asbestos removal operatives under simulated asbestos removal work conditions. The sulfur hexafluoride test method as defined in European Standards was employed to determine the leakage into the respirators. Protection factors were measured on a total of 21 test volunteers. The test method allowed protection factors to be related to wearer activities and practices. Poor fitting techniques and simulated reduction in the respirator's performance resulted in a reduction in the protection factor. Visual inspection of the RPE usually worn by the volunteers identified inadequate maintenance. This study re-emphasises that careful selection, facepiece fit testing and correct use and maintenance of RPE are essential to ensure optimum protection to the wearer.

Cochlear outer-hair-cell efferents and complex-sound-induced hearing loss: protective and opposing effects

Centrifugal crossed and uncrossed medial olivocochlear systems (CMOCS and UMOCS) terminate on cochlear outer hair cells (OHCs) and exercise effects through a nicotinic cholinergic receptor. Hence their cochlear effects have not been differentiated. Recent work on protection from loud-sound-induced temporary threshold shifts (TTSs) in hearing sensitivity suggest the two OHC efferent systems may act differently. This was tested, using traumatic complex sound, to determine if such sound could activate both MOCS components and then reveal whether they exerted different effects on TTSs to such stimuli. Traumatic noise bands activated crossed and uncrossed MOCS efferents. Two different CMOCS effects were observed. For frequencies in the noise (within-band frequencies), it protected hearing sensitivity as expected. Novel findings were that at frequencies higher than the noise band range (high-side frequencies), it acted to worsen hearing sensitivity and that this was opposed by a UMOCS effect generally targeted to these frequency regions. It is proposed that the two crossed MOCS actions are extensions of a contrast-enhancement action for low-level noise bands. It is also proposed that the UMOCS plays a state-restoration role to prevent an undesired CMOCS side-effect of exacerbation of high-side TTSs to high-level noise bands.

Noise priming and the effects of different cochlear centrifugal pathways on loud-sound-induced hearing loss

Priming/conditioning the cochlea with moderately loud sound can reduce damage caused by subsequent loud sound. This study examined immediate effects of short-term priming with monaural broadband noise on temporary threshold shifts (TTSs) in hearing caused by a subsequent loud high-frequency tone and the role of centrifugal olivocochlear pathways. Priming caused delay-dependent changes in tone-induced TTSs, particularly or only at frequencies higher than the peak tone-affected frequency, through two general effects: a short-lasting increase in cochlear susceptibility to loud sound and longer-lasting complex end effects of centrifugal pathways. The results indicated the following points. Priming noise had "pure" cochlear effects, outlasting its presentation and declining with delay, that exacerbated tone-induced TTSs at frequencies higher than the peak tone-affected frequency. The centrifugal uncrossed medial olivocochlear system (UMOCS) could prevent this noise exacerbation and as this noise effect declined, could even reduce tone-induced TTSs below those to the unprimed tone. For longer delays, when priming noise no longer had any exacerbative "pure" cochlear effects on TTSs, UMOCS exacerbated TTSs above those to the unprimed tone. The crossed medial olivocochlear system (CMOCS) appeared to show a gradual "build-up" of effects postpriming. A parallel study showed it exercised no end effect on TTSs when noise and tone were concurrent. With priming, CMOCS effects were observed. For the shortest priming delay, the CMOCS blocked a UMOCS effect preventing noise exacerbation of tone-induced TTSs. For longer delays, CMOCS end effects, when present, reduced tone-induced TTSs below those to the unprimed tone. The CMOCS may oscillate between producing these effects and exerting no end-effect. With increasing delay CMOCS protection occurred in a greater proportion of animals. Finally, with a delay of 600 s between primer and loud tone, all these systems appeared to have reset to normal so that TTSs were similar to those in the unprimed condition. Thus the effects of short-term priming are not simple and do not suggest that centrifugal pathways act automatically as a protective system during such priming.

Effect of whole body hyperthermia on radiation therapy of transplanted fibrosarcoma in Swiss mice

The exposure of normal mice to whole body hyperthermia (1 h WBH at 39 or 40 degrees C), 20 or 48 h prior to total body irradiation (TBI) with lethal doses of gamma-rays affords significant protection as assessed by survival. The radioprotective effect of WBH, as observed in normal mice, diminished in tumour bearing mice depending upon the size of tumour. Treatment of tumour bearing mice with mild WBH, 20 h prior to local irrradiation (LIR), did not protect the transplanted tumour against radiotherapy with a single dose of 20 Gy or fractionated dose (in five fractions) of 7.5 Gy on alternate days. In fact, mild WBH treatment enhanced the tumour regression and increased the mean survival time after fractionated dose therapy. However, the prior mild WBH was found to be ineffective in protecting normal tissue, as assessed by skin contraction after local irradiation (50 Gy). This indicates that mild WBH treatment given 20 h prior to local radiotherapy enhances fibrosarcoma tumour regression but cannot protect skin (normal tissue) against local irradiation. It appears that radioprotection of animals by WBH may be the consequence of its radioprotective effect on haemopoietic tissues mediated through certain cytokines. Perhaps WBH may not have a radioprotective effect on other tissues, as evident from skin contraction studies.

Cortical reorganization in patients with high frequency cochlear hearing loss

Animal research has shown that tonotopic representation in the auditory cortex is not statically fixed in the adult organism but can be altered after deafferentation. The present study examines the plasticity of the human auditory cortex in patients with high frequency cochlear hearing loss by means of magnetoencephalographic measurements. The data show that the cortical map can reorganize such that cortical neurons deprived of their usual most sensitive afferent input now respond to tone frequencies adjacent to the frequency range of the partial hearing loss. The results suggest that deafferentation due to cochlear damage in adults may lead to functional reorganization of auditory cortical structures.

Clinical and sensorimotor gating effects of ketamine in normals

The clinical similarities between PCP psychosis and schizophrenia have contributed importantly to the development of the glutamate hypothesis of schizophrenia. Sensory gating, as measured by prepulse inhibition of the acoustic startle reflex (PPI), is impaired in patients with schizophrenia. In animals, the noncompetitive NMDA antagonists PCP and ketamine disrupt PPI in a way that resembles the defect seen in schizophrenia. The purpose of this work is to investigate the modulation of sensory gating in humans by subanaesthetic doses of ketamine. 16 healthy male subjects received a 60-min infusion of ketamine (0.5 mg/kg) or normal saline on two separate days in a randomized double-blind crossover design. Clinical ratings and PPI were done during the infusion on both days. Ketamine produced robust clinical effects. Dissociative symptoms as measured by the CADSS increased from 0 +/- 0.0 to 29.3 +/- 14.3; negative symptoms (Affect Rating Scale) increased from 17.2 +/- 0.8 to 24.8 +/- 3.1; and total BPRS scores increased from 18.3 +/- 0.8 to 26.4 +/- 5.1. ANOVAs for these ratings were all significant at the p <.000 level, although BPRS increases were not in the range seen in decompensated schizophrenic patients. The amplitudes of the startle responses to pulse-alone stimuli were not significantly different on ketamine and placebo days. Ketamine did not cause disruption in PPI as expected. On the contrary, in the first block of the PPI session ketamine significantly enhanced PPI (ANOVA; F=6.15, p =.026). These results indicate that the clinical effects of ketamine are not coupled with schizophrenic-like disruption of PPI in normal controls.

Injury- and use-related plasticity in adult auditory cortex

After restricted cochlear lesions in adult animals the frequency selectivity of neurons in the cortical region deprived of its normal input by the lesion is changed such that the region is occupied by expanded representations of adjacent (perilesion) frequencies. These changes reflect a dynamic process of reorganization (plasticity) and are not explicable as passive consequences of the lesion. Analogous plasticity of cortical frequency selectivity and organization is seen following behavioural training that enhances the significance of particular acoustic stimuli. The occurrence of injury- and use-related auditory cortical plasticity gives rise to a number of questions relating to the mechanisms involved, the perceptual consequences and functional significance of such plastic changes, and their implications for the central processing of input from prosthetic devices. Evidence relating to these issues is briefly summarized in this review, and the directions of future research are considered.