Listening to another sense: somatosensory integration in the auditory system

Chronic pain - A maladaptive compensation to unbalanced hierarchical predictive processing

The ability to perceive pain presents an interesting evolutionary advantage to adapt to an ever-changing environment. However, in the case of chronic pain (CP), pain perception hinders the capacity of the system to adapt to changing sensory environments. Similar to other chronic perceptual disorders, CP is also proposed to be a maladaptive compensation to aberrant sensory predictive processing. The local-global oddball paradigm relies on learning hierarchical rules and processing environmental irregularities at a local and global level. Prediction errors (PE) between actual and predicted input typically trigger an update of the forward model to limit the probability of encountering future PEs. It has been hypothesised that CP hinders forward model updating, reflected in increased local deviance and decreased global deviance. In the present study, we used the local-global paradigm to examine how CP influences hierarchical learning relative to healthy controls. As hypothesised, we observed that deviance in the stimulus characteristics evoked heightened local deviance and decreased global deviance of the stimulus-driven PE. This is also accompanied by respective changes in theta phase locking that is correlated with the subjective pain perception. Changes in the global deviant in the stimulus-driven-PE could also be explained by dampened attention-related responses. Changing the context of the auditory stimulus did not however show a difference in the context-driven PE. These findings suggest that CP is accompanied by maladaptive forward model updating where the constant presence of pain perception disrupts local deviance in non-nociceptive domains. Furthermore, we hypothesise that the auditory-processing based biomarker identified here could be a marker of domain-general dysfunction that could be confirmed by future research.

The Feel of Speech: Multisystem and Polymodal Somatosensation in Speech Production

PURPOSE

The oral structures such as the tongue and lips have remarkable somatosensory capacities, but understanding the roles of somatosensation in speech production requires a more comprehensive knowledge of somatosensation in the speech production system in its entirety, including the respiratory, laryngeal, and supralaryngeal subsystems. This review was conducted to summarize the system-wide somatosensory information available for speech production.

METHOD

The search was conducted with PubMed/Medline and Google Scholar for articles published until November 2023. Numerous search terms were used in conducting the review, which covered the topics of psychophysics, basic and clinical behavioral research, neuroanatomy, and neuroscience.

RESULTS AND CONCLUSIONS

The current understanding of speech somatosensation rests primarily on the two pillars of psychophysics and neuroscience. The confluence of polymodal afferent streams supports the development, maintenance, and refinement of speech production. Receptors are both canonical and noncanonical, with the latter occurring especially in the muscles innervated by the facial nerve. Somatosensory representation in the cortex is disproportionately large and provides for sensory interactions. Speech somatosensory function is robust over the lifespan, with possible declines in advanced aging. The understanding of somatosensation in speech disorders is largely disconnected from research and theory on speech production. A speech somatoscape is proposed as the generalized, system-wide sensation of speech production, with implications for speech development, speech motor control, and speech disorders.

Neurodegeneration after repeated noise trauma in the mouse lower auditory pathway

High intensity noise exposure leads to a permanent shift in auditory thresholds (PTS), affecting both peripheral (cochlear) tissue and the central auditory system. Studies have shown that a noise-induced hearing loss results in significant cell loss in several auditory structures. Degeneration can be demonstrated within hours after noise exposure, particularly in the lower auditory pathway, and continues to progress over days and weeks following the trauma. However, there is limited knowledge about the effects of recurring acoustic trauma. Repeated noise exposure has been demonstrated to increase neuroplasticity and neural activity. Thus, the present study aimed to investigate the influence of a second noise exposure on the cytoarchitecture of key structures of the auditory pathway, including spiral ganglion neurons (SGN), the ventral and dorsal cochlear nucleus (VCN and DCN, respectively), and the inferior colliculus (IC). In the experiments, young adult normal hearing mice were exposed to noise once or twice (with the second trauma applied one week after the initial exposure) for 3 h, using broadband white noise (5 - 20 kHz) at 115 dB SPL. The cell densities in the investigated auditory structures significantly decreased in response to the initial noise exposure compared to unexposed control animals. These findings are consistent with earlier research, which demonstrated degeneration in the auditory pathway within the first week after acoustic trauma. Additionally, cell densities were significantly decreased after the second trauma, but this effect was only observed in the VCN, with no similar effects seen in the SGN, DCN, or IC. These results illustrate how repeated noise exposure influences the cytoarchitecture of the auditory system. It appears that an initial noise exposure primarily damages the lower auditory pathway, but surviving cellular structures may develop resistance to additional noise-induced injury.

Role of auditory-somatosensory corticothalamic circuit integration in analgesia

Our sensory environment is permeated by a diverse array of auditory and somatosensory stimuli. The pairing of acoustic signals with concurrent or forthcoming tactile cues are abundant in everyday life and various survival contexts across species, thus deeming the ability to integrate sensory inputs arising from the combination of these stimuli as crucial. The corticothalamic system plays a critical role in orchestrating the construction, integration and distribution of the information extracted from these sensory modalities. In this mini-review, we provide a circuit-level description of the auditory corticothalamic pathway in conjunction with adjacent corticothalamic somatosensory projections. Although the extent of the functional interactions shared by these pathways is not entirely elucidated, activation of each of these systems appears to modulate sensory perception in the complementary domain. Several specific issues are reviewed. Under certain environmental noise conditions, the spectral information of a sound could induce modulations in nociception and even induce analgesia. We begin by discussing recent findings by Zhou et al. (2022) implicating the corticothalamic system in mediating sound-induced analgesia. Next, we describe relevant components of the corticothalamic pathway's functional organization. Additionally, we describe an emerging body of literature pointing to intrathalamic circuitry being optimal for controlling and selecting sensory signals across modalities, with the thalamic reticular nucleus being a candidate mechanism for directing cross-modal interactions. Finally, Ca2+ bursting in thalamic neurons evoked by the thalamic reticular nucleus is explored.

A parahippocampal-sensory Bayesian vicious circle generates pain or tinnitus: a source-localized EEG study

Pain and tinnitus share common pathophysiological mechanisms, clinical features, and treatment approaches. A source-localized resting-state EEG study was conducted in 150 participants: 50 healthy controls, 50 pain, and 50 tinnitus patients. Resting-state activity as well as functional and effective connectivity was computed in source space. Pain and tinnitus were characterized by increased theta activity in the pregenual anterior cingulate cortex, extending to the lateral prefrontal cortex and medial anterior temporal lobe. Gamma-band activity was increased in both auditory and somatosensory cortex, irrespective of the pathology, and extended to the dorsal anterior cingulate cortex and parahippocampus. Functional and effective connectivity were largely similar in pain and tinnitus, except for a parahippocampal-sensory loop that distinguished pain from tinnitus. In tinnitus, the effective connectivity between parahippocampus and auditory cortex is bidirectional, whereas the effective connectivity between parahippocampus and somatosensory cortex is unidirectional. In pain, the parahippocampal-somatosensory cortex is bidirectional, but parahippocampal auditory cortex unidirectional. These modality-specific loops exhibited theta-gamma nesting. Applying a Bayesian brain model of brain functioning, these findings suggest that the phenomenological difference between auditory and somatosensory phantom percepts result from a vicious circle of belief updating in the context of missing sensory information. This finding may further our understanding of multisensory integration and speaks to a universal treatment for pain and tinnitus-by selectively disrupting parahippocampal-somatosensory and parahippocampal-auditory theta-gamma activity and connectivity.

Integration of somatosensory and motor-related information in the auditory system

An ability to integrate information provided by different sensory modalities is a fundamental feature of neurons in many brain areas. Because visual and auditory inputs often originate from the same external object, which may be located some distance away from the observer, the synthesis of these cues can improve localization accuracy and speed up behavioral responses. By contrast, multisensory interactions occurring close to the body typically involve a combination of tactile stimuli with other sensory modalities. Moreover, most activities involving active touch generate sound, indicating that stimuli in these modalities are frequently experienced together. In this review, we examine the basis for determining sound-source distance and the contribution of auditory inputs to the neural encoding of space around the body. We then consider the perceptual consequences of combining auditory and tactile inputs in humans and discuss recent evidence from animal studies demonstrating how cortical and subcortical areas work together to mediate communication between these senses. This research has shown that somatosensory inputs interface with and modulate sound processing at multiple levels of the auditory pathway, from the cochlear nucleus in the brainstem to the cortex. Circuits involving inputs from the primary somatosensory cortex to the auditory midbrain have been identified that mediate suppressive effects of whisker stimulation on auditory thalamocortical processing, providing a possible basis for prioritizing the processing of tactile cues from nearby objects. Close links also exist between audition and movement, and auditory responses are typically suppressed by locomotion and other actions. These movement-related signals are thought to cancel out self-generated sounds, but they may also affect auditory responses via the associated somatosensory stimulation or as a result of changes in brain state. Together, these studies highlight the importance of considering both multisensory context and movement-related activity in order to understand how the auditory cortex operates during natural behaviors, paving the way for future work to investigate auditory-somatosensory interactions in more ecological situations.

Intrinsic Noise Improves Speech Recognition in a Computational Model of the Auditory Pathway

Noise is generally considered to harm information processing performance. However, in the context of stochastic resonance, noise has been shown to improve signal detection of weak sub- threshold signals, and it has been proposed that the brain might actively exploit this phenomenon. Especially within the auditory system, recent studies suggest that intrinsic noise plays a key role in signal processing and might even correspond to increased spontaneous neuronal firing rates observed in early processing stages of the auditory brain stem and cortex after hearing loss. Here we present a computational model of the auditory pathway based on a deep neural network, trained on speech recognition. We simulate different levels of hearing loss and investigate the effect of intrinsic noise. Remarkably, speech recognition after hearing loss actually improves with additional intrinsic noise. This surprising result indicates that intrinsic noise might not only play a crucial role in human auditory processing, but might even be beneficial for contemporary machine learning approaches.

Topographic and widespread auditory modulation of the somatosensory cortex: potential for bimodal sound and body stimulation for pain treatment

OBJECTIVE

There has been growing interest in understanding multisensory integration in the cortex through activation of multiple sensory and motor pathways to treat brain disorders, such as tinnitus or essential tremors. For tinnitus, previous studies show that combined sound and body stimulation can modulate the auditory pathway and lead to significant improvements in tinnitus symptoms. Considering that tinnitus is a type of chronic auditory pain, bimodal stimulation could potentially alter activity in the somatosensory pathway relevant for treating chronic pain. As an initial step towards that goal, we mapped and characterized neuromodulation effects in the somatosensory cortex (SC) in response to sound and/or electrical stimulation of the body.

APPROACH

We first mapped the topographic organization of activity across the SC of ketamine-anesthetized guinea pigs through electrical stimulation of different body locations using subcutaneous needle electrodes or with broadband acoustic stimulation. We then characterized how neural activity in different parts of the SC could be facilitated or suppressed with bimodal stimulation.

MAIN RESULTS

The topography in the SC of guinea pigs in response to electrical stimulation of the body aligns consistently to that shown in previous rodent studies. Interestingly, auditory broadband noise stimulation primarily excited SC areas that typically respond to stimulation of lower body locations. Although there was only a small subset of SC locations that were excited by acoustic stimulation alone, all SC recording sites could be altered (facilitated or suppressed) with bimodal stimulation. Furthermore, specific regions of the SC could be modulated by stimulating an appropriate body region combined with broadband noise.

SIGNIFICANCE

These findings show that bimodal stimulation can excite or modulate firing across a widespread yet targeted population of SC neurons. This approach may provide a non-invasive method for altering or disrupting abnormal firing patterns within certain parts of the SC for chronic pain treatment.

The promise of low-tech intervention in a high-tech era: Remodeling pathological brain circuits using behavioral reverse engineering

As an academic pursuit, neuroscience is enjoying a golden age. From a clinical perspective, our field is failing. Conventional 20th century drugs and devices are not well-matched to the heterogeneity, scale, and connectivity of neural circuits that produce aberrant mental states and behavior. Laboratory-based methods for editing neural genomes and sculpting activity patterns are exciting, but their applications for hundreds of millions of people with mental health disorders is uncertain. We argue that mechanisms for regulating adult brain plasticity and remodeling pathological activity are substantially pre-wired, and we suggest new minimally invasive strategies to harness and direct these endogenous systems. Drawing from studies across the neuroscience literature, we describe approaches that identify neural biomarkers more closely linked to upstream causes-rather than downstream consequences-of disordered behavioral states. We highlight the potential for innovation and discovery in reverse engineering approaches that refine bespoke behavioral "agonists" to drive upstream neural biomarkers in normative directions and reduce clinical symptoms for select classes of neuropsychiatric disorders.

Brain Morphological Modifications in Congenital and Acquired Auditory Deprivation: A Systematic Review and Coordinate-Based Meta-Analysis

Neuroplasticity following deafness has been widely demonstrated in both humans and animals, but the anatomical substrate of these changes is not yet clear in human brain. However, it is of high importance since hearing loss is a growing problem due to aging population. Moreover, knowing these brain changes could help to understand some disappointing results with cochlear implant, and therefore could improve hearing rehabilitation. A systematic review and a coordinate-based meta-analysis were realized about the morphological brain changes highlighted by MRI in severe to profound hearing loss, congenital and acquired before or after language onset. 25 papers were included in our review, concerning more than 400 deaf subjects, most of them presenting prelingual deafness. The most consistent finding is a volumetric decrease in gray matter around bilateral auditory cortex. This change was confirmed by the coordinate-based meta-analysis which shows three converging clusters in this region. The visual areas of deaf children is also significantly impacted, with a decrease of the volume of both gray and white matters. Finally, deafness is responsible of a gray matter increase within the cerebellum, especially at the right side. These results are largely discussed and compared with those from deaf animal models and blind humans, which demonstrate for example a much more consistent gray matter decrease along their respective primary sensory pathway. In human deafness, a lot of other factors than deafness could interact on the brain plasticity. One of the most important is the use of sign language and its age of acquisition, which induce among others changes within the hand motor region and the visual cortex. But other confounding factors exist which have been too little considered in the current literature, such as the etiology of the hearing impairment, the speech-reading ability, the hearing aid use, the frequent associated vestibular dysfunction or neurocognitive impairment. Another important weakness highlighted by this review concern the lack of papers about postlingual deafness, whereas it represents most of the deaf population. Further studies are needed to better understand these issues, and finally try to improve deafness rehabilitation.

Sensory profile of children with Central Auditory Processing Disorder (CAPD)

PURPOSE

To analyze the sensory profile of children with auditory sensory processing disorder according to the Child Sensory Profile 2 and to verify potential associations between central auditory processing and sensory processing.

METHODS

Sixty children from two public schools in the city of João Pessoa, state of Paraíba, were evaluated. All children had their cognitive skills tested and their socioeconomic and demographic information collected. The children's hearing, central auditory processing, and sensory processing were evaluated. SPSS Statistics version 25.0 was used for data analysis and the significant value adopted was 0.05. Descriptive analysis was performed using the central tendency method. The similarities among the test variables were measured by Student's t-test and Mann-Whitney U test. The effect size (ES) between the groups was measured by Cohen's d or Rosenthal's r coefficient.

RESULTS

The average age of children with CAPD was 8.4 years, and their families had lower levels of income and education when compared to those without the disorder. Children with CAPD present more sensory differences than their peers with normative CAP. The Child Sensory Processing 2 results didn't show any statistic associations with central auditory processing, and the effect size was of moderate magnitude for the visual system.

CONCLUSION

Children with CAPD have more sensory differences than their peers according to the normative results of the Child Sensory Profile 2. An association between sensory and central auditory processing was not observed, except for the visual system.

Tinnitus-like "hallucinations" elicited by sensory deprivation in an entropy maximization recurrent neural network

Sensory deprivation has long been known to cause hallucinations or "phantom" sensations, the most common of which is tinnitus induced by hearing loss, affecting 10-20% of the population. An observable hearing loss, causing auditory sensory deprivation over a band of frequencies, is present in over 90% of people with tinnitus. Existing plasticity-based computational models for tinnitus are usually driven by homeostatic mechanisms, modeled to fit phenomenological findings. Here, we use an objective-driven learning algorithm to model an early auditory processing neuronal network, e.g., in the dorsal cochlear nucleus. The learning algorithm maximizes the network's output entropy by learning the feed-forward and recurrent interactions in the model. We show that the connectivity patterns and responses learned by the model display several hallmarks of early auditory neuronal networks. We further demonstrate that attenuation of peripheral inputs drives the recurrent network towards its critical point and transition into a tinnitus-like state. In this state, the network activity resembles responses to genuine inputs even in the absence of external stimulation, namely, it "hallucinates" auditory responses. These findings demonstrate how objective-driven plasticity mechanisms that normally act to optimize the network's input representation can also elicit pathologies such as tinnitus as a result of sensory deprivation.

Auditory noise improves balance control by cross-modal stochastic resonance

It is known that enhanced somatosensory function leads to improved balance, and somatosensory function can be enhanced by the appropriate level of mechanical, visual, or auditory noise. In this study, we tested the potential benefit of an auditory noise on balance control. We first assessed static balance by measuring 10 times the duration of standing on the toes of one leg with closed eyes. For the 18 healthy adult participants, the median standing times ranged from 2.1 to 45.6 s, and the median of the distribution was 9.9 s. From the above, the participants were divided into two groups: lower (below 10 s, n = 9) and higher (above 10 s, n = 9) balance groups. We then investigated the effect on balance control of an auditory white noise emitted at the detection threshold. Each individual performed 20 trials. The auditory noise was applied in half the trials, while the remaining trials were conducted without noise. The order of the noise and no-noise trials was quasi-random. In the lower-balance group, the median standing time significantly increased during the noise trials (10.3 s) compared with the time in the no-noise controls (5.2 s). On the other hand, noise had no significant effect in the higher-balance group, presumably because of a ceiling effect. These findings suggest that static balance in the lower-balance participants can be improved by applying a weak noise through cross-modal stochastic resonance.

Neuroplasticity and Crossmodal Connectivity in the Normal, Healthy Brain

Objective

Neuroplasticity enables the brain to establish new crossmodal connections or reorganize old connections which are essential to perceiving a multisensorial world. The intent of this review is to identify and summarize the current developments in neuroplasticity and crossmodal connectivity, and deepen understanding of how crossmodal connectivity develops in the normal, healthy brain, highlighting novel perspectives about the principles that guide this connectivity.

Methods

To the above end, a narrative review is carried out. The data documented in prior relevant studies in neuroscience, psychology and other related fields available in a wide range of prominent electronic databases are critically assessed, synthesized, interpreted with qualitative rather than quantitative elements, and linked together to form new propositions and hypotheses about neuroplasticity and crossmodal connectivity.

Results

Three major themes are identified. First, it appears that neuroplasticity operates by following eight fundamental principles and crossmodal integration operates by following three principles. Second, two different forms of crossmodal connectivity, namely direct crossmodal connectivity and indirect crossmodal connectivity, are suggested to operate in both unisensory and multisensory perception. Third, three principles possibly guide the development of crossmodal connectivity into adulthood. These are labeled as the principle of innate crossmodality, the principle of evolution-driven 'neuromodular' reorganization and the principle of multimodal experience. These principles are combined to develop a three-factor interaction model of crossmodal connectivity.

Conclusions

The hypothesized principles and the proposed model together advance understanding of neuroplasticity, the nature of crossmodal connectivity, and how such connectivity develops in the normal, healthy brain.

Hearing Loss in Neurological Disorders

Sensorineural hearing loss (SNHL) affects approximately 466 million people worldwide, which is projected to reach 900 million by 2050. Its histological characteristics are lesions in cochlear hair cells, supporting cells, and auditory nerve endings. Neurological disorders cover a wide range of diseases affecting the nervous system, including Alzheimer's disease (AD), Parkinson's disease (PD), Huntington's disease (HD), autism spectrum disorder (ASD), etc. Many studies have revealed that neurological disorders manifest with hearing loss, in addition to typical nervous symptoms. The prevalence, manifestations, and neuropathological mechanisms underlying vary among different diseases. In this review, we discuss the relevant literature, from clinical trials to research mice models, to provide an overview of auditory dysfunctions in the most common neurological disorders, particularly those associated with hearing loss, and to explain their underlying pathological and molecular mechanisms.

Electro-Tactile Stimulation Enhances Cochlear-Implant Melody Recognition: Effects of Rhythm and Musical Training

OBJECTIVES

Electro-acoustic stimulation (EAS) enhances speech and music perception in cochlear-implant (CI) users who have residual low-frequency acoustic hearing. For CI users who do not have low-frequency acoustic hearing, tactile stimulation may be used in a similar fashion as residual low-frequency acoustic hearing to enhance CI performance. Previous studies showed that electro-tactile stimulation (ETS) enhanced speech recognition in noise and tonal language perception for CI listeners. Here, we examined the effect of ETS on melody recognition in both musician and nonmusician CI users.

DESIGN

Nine musician and eight nonmusician CI users were tested in a melody recognition task with or without rhythmic cues in three testing conditions: CI only (E), tactile only (T), and combined CI and tactile stimulation (ETS).

RESULTS

Overall, the combined electrical and tactile stimulation enhanced the melody recognition performance in CI users by 9% points. Two additional findings were observed. First, musician CI users outperformed nonmusicians CI users in melody recognition, but the size of the enhancement effect was similar between the two groups. Second, the ETS enhancement was significantly higher with nonrhythmic melodies than rhythmic melodies in both groups.

CONCLUSIONS

These findings suggest that, independent of musical experience, the size of the ETS enhancement depends on integration efficiency between tactile and auditory stimulation, and that the mechanism of the ETS enhancement is improved electric pitch perception. The present study supports the hypothesis that tactile stimulation can be used to improve pitch perception in CI users.

Subcortical circuits mediate communication between primary sensory cortical areas in mice

Integration of information across the senses is critical for perception and is a common property of neurons in the cerebral cortex, where it is thought to arise primarily from corticocortical connections. Much less is known about the role of subcortical circuits in shaping the multisensory properties of cortical neurons. We show that stimulation of the whiskers causes widespread suppression of sound-evoked activity in mouse primary auditory cortex (A1). This suppression depends on the primary somatosensory cortex (S1), and is implemented through a descending circuit that links S1, via the auditory midbrain, with thalamic neurons that project to A1. Furthermore, a direct pathway from S1 has a facilitatory effect on auditory responses in higher-order thalamic nuclei that project to other brain areas. Crossmodal corticofugal projections to the auditory midbrain and thalamus therefore play a pivotal role in integrating multisensory signals and in enabling communication between different sensory cortical areas.

Careful whispers: when sounds feel like a touch

There are anatomical and functional links between auditory and somatosensory processing. We suggest that these links form the basis for the popular internet phenomenon where people enjoy a sense of touch from auditory (and often audiovisual) stimuli.

Audiotactile interactions in the mouse cochlear nucleus

Multisensory integration of auditory and tactile information occurs already at the level of the cochlear nucleus. Rodents use their whiskers for tactile perception to guide them in their exploration of the world. As nocturnal animals with relatively poor vision, audiotactile interactions are of great importance for this species. Here, the influence of whisker deflections on sound-evoked spiking in the cochlear nucleus was investigated in vivo in anesthetized mice. Multichannel, silicon-probe electrophysiological recordings were obtained from both the dorsal and ventral cochlear nucleus. Whisker deflections evoked an increased spiking activity in fusiform cells of the dorsal cochlear nucleus and t-stellate cells in ventral cochlear nucleus, whereas bushy cells in the ventral cochlear nucleus showed a more variable response. The response to broadband noise stimulation increased in fusiform cells and primary-like bushy cells when the sound stimulation was preceded (~ 20 ms) by whisker stimulation. Multi-sensory integration of auditory and whisker input can thus occur already in this early brainstem nucleus, emphasizing the importance of early integration of auditory and somatosensory information.

The stochastic resonance model of auditory perception: A unified explanation of tinnitus development, Zwicker tone illusion, and residual inhibition

Stochastic resonance (SR) has been proposed to play a major role in auditory perception, and to maintain optimal information transmission from the cochlea to the auditory system. By this, the auditory system could adapt to changes of the auditory input at second or even sub-second timescales. In case of reduced auditory input, somatosensory projections to the dorsal cochlear nucleus would be disinhibited in order to improve hearing thresholds by means of SR. As a side effect, the increased somatosensory input corresponding to the observed tinnitus-associated neuronal hyperactivity is then perceived as tinnitus. In addition, the model can also explain transient phantom tone perceptions occurring after ear plugging, or the Zwicker tone illusion. Vice versa, the model predicts that via stimulation with acoustic noise, SR would not be needed to optimize information transmission, and hence somatosensory noise would be tuned down, resulting in a transient vanishing of tinnitus, an effect referred to as residual inhibition.

Speech Discrimination Tasks: A Sensitive Sensory and Cognitive Measure in Early and Mild Multiple Sclerosis

There is a need for reliable and objective measures of early and mild symptomology in multiple sclerosis (MS), as deficits can be subtle and difficult to quantify objectively in patients without overt physical deficits. We hypothesized that a speech-in-noise (SiN) task would be sensitive to demyelinating effects on precise neural timing and diffuse higher-level networks required for speech intelligibility, and therefore be a useful tool for monitoring sensory and cognitive changes in early MS. The objective of this study was to develop a SiN task for clinical use that sensitively monitors disease activity in early (<5 years) and late (>10 years) stages of MS subjects with mild severity [Expanded Disability Status Scale (EDSS) score < 3]. Pre-recorded Bamford-Kowal-Bench sentences and isolated keywords were presented at five signal-to-noise ratios (SNR) in one of two background noises: speech-weighted noise and eight-talker babble. All speech and noise were presented via headphones to controls (n = 38), early MS (n = 23), and late MS (n = 12) who were required to verbally repeat the target speech. MS subjects also completed extensive neuropsychological testing which included: Paced Auditory Serial Addition Test, Digit Span Test, and California Verbal Learning Test. Despite normal hearing thresholds, subjects with early and late mild MS displayed speech discrimination deficits when sentences and words were presented in babble - but not speech-weighted noise. Significant correlations between SiN performance and standardized neuropsychological assessments indicated that MS subjects with lower functional scores also had poorer speech discrimination. Furthermore, a quick 5-min task with words and keywords presented in multi-talker babble at an SNR of -1 dB was 82% accurate in discriminating mildly impaired MS individuals (median EDSS = 0) from healthy controls. Quantifying functional deficits in mild MS will help clinicians to maximize the opportunities to preserve neurological reserve in patients with appropriate therapeutic management, particularly in the earliest stages. Given that physical assessments are not informative in this fully ambulatory cohort, a quick 5-min task with words and keywords presented in multi-talker babble at a single SNR could serve as a complementary test for clinical use due to its ease of use and speed.

Speech discrimination impairments as a marker of disease severity in multiple sclerosis

BACKGROUND

Multiple Sclerosis (MS) pathology is likely to disrupt central auditory pathways, thereby affecting an individual's ability to discriminate speech from noise. Despite the importance of speech discrimination in daily communication, it's characterization in the context of MS remains limited. This cross-sectional study evaluated speech discrimination in MS under "real world" conditions where sentences were presented in ecologically valid multi-talker speech or broadband noise at several signal-to-noise ratios (SNRs).

METHODS

Pre-recorded Bamford-Kowal-Bench sentences were presented at five signal-to-noise ratios (SNR) in one of two background noises: speech-weighted noise and eight-talker babble. All auditory stimuli were presented via headphones to control (n = 38) and MS listeners with mild (n = 20), moderate (n = 16) and advanced (n = 10) disability. Disability was quantified by the Kurtzke Expanded Disability Status Scale (EDSS) and scored by a neurologist. All participants passed a routine audiometric examination.

RESULTS

Despite normal hearing, MS psychometric discrimination curves which model the relationship between signal-to-noise ratio (SNR) and sentence discrimination accuracy in speech-weighted noise and babble did not change in slope (sentences/dB) but shifted to higher SNRs (dB) compared to controls. The magnitude of the shift in the curve systematically increased with greater disability. Furthermore, mixed-effects models identified EDSS score as the most significant predictor of speech discrimination in noise (odds ratio = 0.81; p < 0.001). Neither age, sex, disease phenotype or disease duration were significantly associated with speech discrimination performance in noise. Only MS listeners with advanced disability self-reported audio-attentional difficulty in a questionnaire designed to reflect auditory processing behaviours in daily life.

CONCLUSION

Speech discrimination performance worsened systematically with greater disability, independent of age, sex, education, disease duration or disease phenotype. These results identify novel auditory processing deficits in MS and highlight that speech discrimination tasks may provide a viable non-invasive and sensitive means for disease monitoring in MS.

Lidocaine injections to the otic ganglion for the treatment of tinnitus-A pilot study

Tinnitus is defined as the perception of noise without an external acoustic stimulus. Due to the heterogeneity of tinnitus, no treatment has proven equally beneficial to every single of these patients. Previous studies have shown that trigeminal input can interfere with the perception of tinnitus. Therefore, we aimed to explore the therapeutic potential of lidocaine injections in trigeminal structures. We conducted a pilot study with 19 participants to explore feasibility and tolerability of this approach. The intervention consisted of three injections of lidocaine in the anatomical area of the trigeminal ganglion and the ganglion oticum via an oral approach corresponding to the affected side of tinnitus. We performed an assessment that included the Mini-TQ, CGII, and numeric rating scales of tinnitus loudness and severity at different time points over a follow-up period of 12 weeks. In addition to changes of subjective tinnitus complaints, potential adverse events were documented. Patients were treated at the Centre of Otorhinolaryngology in Traunstein, Germany, and data were analyzed at the University of Regensburg, Germany. We did not observe any relevant side effects. There was a significant reduction of tinnitus distress (Mini-TQ, Tinnitus severity) and loudness (measured subjectively) over time. Our pilot data suggests that lidocaine injections targeting trigeminal structures may be able to reduce tinnitus complaints. Future studies should investigate the effects of lidocaine injections in placebo-controlled trials in an extended sample size to further explore the potential benefits of this therapeutic approach on tinnitus.

Lingual electrotactile discrimination ability is associated with the presence of specific connective tissue structures (papillae) on the tongue surface

Electrical stimulation of nerve endings in the tongue can be used to communicate information to users and has been shown to be highly effective in sensory substitution applications. The anterior tip of the tongue has very small somatosensory receptive fields, comparable to those of the finger tips, allowing for precise two-point discrimination and high tactile sensitivity. However, perception of electrotactile stimuli varies significantly between users, and across the tongue surface. Despite this, previous studies all used uniform electrode grids to stimulate a region of the dorsal-medial tongue surface. In an effort to customize electrode layouts for individual users, and thus improve efficacy for sensory substitution applications, we investigated whether specific neuroanatomical and physiological features of the tongue are associated with enhanced ability to perceive active electrodes. Specifically, the study described here was designed to test whether fungiform papillae density and/or propylthiouracil sensitivity are positively or negatively associated with perceived intensity and/or discrimination ability for lingual electrotactile stimuli. Fungiform papillae number and distribution were determined for 15 participants and they were exposed to patterns of electrotactile stimulation (ETS) and asked to report perceived intensity and perceived number of stimuli. Fungiform papillae number and distribution were then compared to ETS characteristics using comprehensive and rigorous statistical analyses. Our results indicate that fungiform papillae density is correlated with enhanced discrimination ability for electrical stimuli. In contrast, papillae density, on average, is not correlated with perceived intensity of active electrodes. However, results for at least one participant suggest that further research is warranted. Our data indicate that propylthiouracil taster status is not related to ETS perceived intensity or discrimination ability. These data indicate that individuals with higher fungiform papillae number and density in the anterior medial tongue region may be better able to use lingual ETS for sensory substitution.

Circuit Mechanisms Underlying the Segregation and Integration of Parallel Processing Streams in the Inferior Colliculus

The lateral cortex of the inferior colliculus (LCIC) forms a nexus between diverse multisensory, motor, and neuromodulatory streams. Like other integration hubs, it contains repeated neurochemical motifs with distinct inputs: GABA-rich modules are innervated by somatosensory structures, while auditory inputs to the LCIC target the surrounding extramodular matrix. To investigate potential mechanisms of convergence between these input streams, we used laser photostimulation circuit mapping to interrogate local LCIC circuits in adult mice of both sexes and found that input patterns are highly dependent on cell type (GABAergic/non-GABAergic) and location (module/matrix). At the circuit level, these inputs yield a directional flow of local information, primarily from the matrix to the modules. Further, the two compartments were found to project to distinct targets in the midbrain and thalamus. These data show that, while connectional modularity in the LCIC gives rise to segregated input-output channels, local circuits provide the architecture for integration between these two streams.SIGNIFICANCE STATEMENT Modularity is a widespread motif across the brain involving the segregation of structures into discrete subregions based on dichotomies in neurochemical expression or connectivity. The inferior colliculus is one such modular structure, containing auditory-recipient matrix regions and GABA-rich modules that are innervated by somatosensory inputs. While modularity suggests segregation of processing streams, here we show that local circuits in the inferior colliculus connect the module and matrix regions, providing an avenue for integration of information across compartments.

A Temporal Sampling Basis for Visual Processing in Developmental Dyslexia

Knowledge of oscillatory entrainment and its fundamental role in cognitive and behavioral processing has increasingly been applied to research in the field of reading and developmental dyslexia. Growing evidence indicates that oscillatory entrainment to theta frequency spoken language in the auditory domain, along with cross-frequency theta-gamma coupling, support phonological processing (i.e., cognitive encoding of linguistic knowledge gathered from speech) which is required for reading. This theory is called the temporal sampling framework (TSF) and can extend to developmental dyslexia, such that inadequate temporal sampling of speech-sounds in people with dyslexia results in poor theta oscillatory entrainment in the auditory domain, and thus a phonological processing deficit which hinders reading ability. We suggest that inadequate theta oscillations in the visual domain might account for the many magno-dorsal processing, oculomotor control and visual deficits seen in developmental dyslexia. We propose two possible models of a magno-dorsal visual correlate to the auditory TSF: (1) A direct correlate that involves "bottom-up" magnocellular oscillatory entrainment of the visual domain that occurs when magnocellular populations phase lock to theta frequency fixations during reading and (2) an inverse correlate whereby attending to text triggers "top-down" low gamma signals from higher-order visual processing areas, thereby organizing magnocellular populations to synchronize to a theta frequency to drive the temporal control of oculomotor movements and capturing of letter images at a higher frequency.

Unisensory and Multisensory Responses in Fetal Alcohol Spectrum Disorders (FASD): Effects of Spatial Congruence

While it is generally accepted that structural and functional brain deficits underlie the behavioral deficits associated with Fetal Alcohol Spectrum Disorders (FASD), the degree to which these problems are expressed in sensory pathology is unknown. Electrophysiological measures indicate that neural processing is delayed in visual and auditory domains. Furthermore, multiple reports of white matter deficits due to prenatal alcohol exposure indicate altered cortical connectivity in individuals with FASD. Multisensory integration requires close coordination between disparate cortical areas leading us to hypothesize that individuals with FASD will have impaired multisensory integration relative to healthy control (HC) participants. Participants' neurophysiological responses were recorded using magnetoencephalography (MEG) during passive unisensory or simultaneous, spatially congruent or incongruent multisensory auditory and somatosensory stimuli. Source timecourses from evoked responses were estimated using multi-dipole spatiotemporal modeling. Auditory M100 response latency was faster for the multisensory relative to the unisensory condition but no group differences were observed. M200 auditory latency to congruent stimuli was earlier and congruent amplitude was larger in participants with FASD relative to controls. Somatosensory M100 response latency was faster in right hemisphere for multisensory relative to unisensory stimulation in both groups. FASD participants' somatosensory M200 responses were delayed by 13 ms, but only for the unisensory presentation of the somatosensory stimulus. M200 results indicate that unisensory and multisensory processing is altered in FASD; it remains to be seen if the multisensory response represents a normalization of the unisensory deficits.

Amino acid and acetylcholine chemistry in mountain beaver cochlear nucleus and comparisons to pocket gopher, other rodents, and cat

The mountain beaver and pocket gopher are two rodents that live mostly underground in tunnel systems. Previous studies have suggested that their cochlear nucleus structure, particularly that of the dorsal cochlear nucleus (DCN), differs significantly from that of other mammals, that the hearing ability of the pocket gopher is deficient compared to that of other rodents, and that the DCN of the mountain beaver is more responsive to slow oscillations of air pressure than to sounds. We conducted some electrophysiological recordings from mountain beaver DCN and then used microchemical methods to map in mountain beaver cochlear nuclei the distributions of amino acids, including the major neurotransmitters of the brain, and enzyme activities related to the metabolism of the neurotransmitter acetylcholine, which functions in centrifugal pathways to the cochlear nucleus. Similar measurements were made for a pocket gopher cochlear nucleus. Responses to tonal stimuli were found in mountain beaver DCN. Distributions and magnitudes of neurotransmitter and related amino acids within mountain beaver and pocket gopher cochlear nuclei were not very different from those of other rodents and cat. However, the enzyme of synthesis for acetylcholine, choline acetyltransferase, had only low activities in the DCN of both mountain beaver and pocket gopher. The chemical distributions in the mountain beaver DCN support a conclusion that it corresponds to just the superficial DCN portion of other mammals. High correlations between the concentrations of γ-aminobutyrate (GABA) and glycine were found for both mountain beaver and pocket gopher cochlear nuclei, suggesting that their co-localization in cochlear nucleus synapses may be especially prominent in these animals. Previous evidence suggests convergence of somatosensory and auditory information in the DCN, and this may be especially true in animals spending most of their time underground. Our results suggest that the enlarged DCN of the mountain beaver and that of the pocket gopher are not very different from those of other rodents with respect to involvement of amino acid neurotransmitters, but they appear to have reduced cholinergic innervation.

Tonotopic and non-auditory organization of the mouse dorsal inferior colliculus revealed by two-photon imaging

The dorsal (DCIC) and lateral cortices (LCIC) of the inferior colliculus are major targets of the auditory and non-auditory cortical areas, suggesting a role in complex multimodal information processing. However, relatively little is known about their functional organization. We utilized in vivo two-photon Ca²⁺ imaging in awake mice expressing GCaMP6s in GABAergic or non-GABAergic neurons in the IC to investigate their spatial organization. We found different classes of temporal responses, which we confirmed with simultaneous juxtacellular electrophysiology. Both GABAergic and non-GABAergic neurons showed spatial microheterogeneity in their temporal responses. In contrast, a robust, double rostromedial-caudolateral gradient of frequency tuning was conserved between the two groups, and even among the subclasses. This, together with the existence of a subset of neurons sensitive to spontaneous movements, provides functional evidence for redefining the border between DCIC and LCIC.

Intermittent theta burst stimulation over right somatosensory larynx cortex enhances vocal pitch-regulation in nonsingers

While the significance of auditory cortical regions for the development and maintenance of speech motor coordination is well established, the contribution of somatosensory brain areas to learned vocalizations such as singing is less well understood. To address these mechanisms, we applied intermittent theta burst stimulation (iTBS), a facilitatory repetitive transcranial magnetic stimulation (rTMS) protocol, over right somatosensory larynx cortex (S1) and a nonvocal dorsal S1 control area in participants without singing experience. A pitch-matching singing task was performed before and after iTBS to assess corresponding effects on vocal pitch regulation. When participants could monitor auditory feedback from their own voice during singing (Experiment I), no difference in pitch-matching performance was found between iTBS sessions. However, when auditory feedback was masked with noise (Experiment II), only larynx-S1 iTBS enhanced pitch accuracy (50-250 ms after sound onset) and pitch stability (>250 ms after sound onset until the end). Results indicate that somatosensory feedback plays a dominant role in vocal pitch regulation when acoustic feedback is masked. The acoustic changes moreover suggest that right larynx-S1 stimulation affected the preparation and involuntary regulation of vocal pitch accuracy, and that kinesthetic-proprioceptive processes play a role in the voluntary control of pitch stability in nonsingers. Together, these data provide evidence for a causal involvement of right larynx-S1 in vocal pitch regulation during singing.

BOLD fMRI effects of transcutaneous vagus nerve stimulation in patients with chronic tinnitus

Objective

Vagus nerve stimulation (VNS) is a neuromodulation method used for treatment of epilepsy and depression. Transcutaneous VNS (tVNS) has been gaining popularity as a noninvasive alternative to VNS. Previous tVNS neuroimaging studies revealed brain (de)activation patterns that involved multiple areas implicated in tinnitus generation and perception. In this study, functional magnetic resonance imaging (fMRI) was used to explore the effects of tVNS on brain activity in patients with tinnitus.

Methods

Thirty-six patients with chronic tinnitus received tVNS to the inner tragus, cymba conchae, and earlobe (sham stimulation).

Results

The locus coeruleus and nucleus of the solitary tract in the brainstem were activated in response to stimulation of both locations compared with the sham stimulation. The cochlear nuclei were also activated, which was not observed in healthy subjects with normal hearing. Multiple auditory and limbic structures, as well as other brain areas associated with generation and perception of tinnitus, were deactivated by tVNS, particularly the parahippocampal gyrus, which was recently speculated to cause tinnitus in hearing-impaired patients.

Conclusions

tVNS via the inner tragus or cymba conchae suppressed neural activity in the auditory, limbic, and other tinnitus-related non-auditory areas through auditory and vagal ascending pathways in tinnitus patients. The results from this study are discussed in the context of several existing models of tinnitus. They indicate that the mechanism of action of tVNS might be involved in multiple brain areas responsible for the generation of tinnitus, tinnitus-related emotional annoyance, and their mutual reinforcement.

Selectivity of Monaural Synaptic Inputs Underlying Binaural Auditory Information Integration in the Central Nucleus of Inferior Colliculus

Neurons in the central nucleus of the inferior colliculus (ICC) receive ascending inputs from the ipsilateral and contralateral auditory pathway. However, the contributions of excitatory or inhibitory synaptic inputs evoked by ipsilateral and contralateral stimuli to auditory responses of ICC neurons remain unclear. Using in vivo whole-cell voltage-clamp recordings, we investigated excitatory and inhibitory synaptic currents in neurons of the ICC in response to binaural stimulation by performing an intensity-intensity scan. To systematically analyze the contribution of the ipsilateral and contralateral ear, the sound intensity was randomly delivered to each side from 0 dB sound pressure level (SPL) to 70 dB SPL. Although the synaptic responses were dominated by contralateral inputs at weak sound intensities, they could be increased (or decreased) by additional ipsilateral stimulation at higher intensities. Interestingly, the synaptic responses to contralateral acoustic inputs were not linearly superimposed with the ipsilateral ones. By contrast, the responses showed either a contralateral or ipsilateral profile, depending on which one was more dominant. This change occurred at a certain intensity “switch” point. Thus, the binaural auditory responses of the ICC neurons were not simply mediated by the summation of the inputs evoked by ipsilateral and contralateral stimulations. This suggested that the ICC might inherit the acoustic information integrated at the brainstem, causing the selectivity of monaural excitation and inhibition to underlie the neuronal binaural acoustic response.

Robust Subthreshold Cross-modal Modulation of Auditory Response by Cutaneous Electrical Stimulation in First- and Higher-order Auditory Thalamic Nuclei

Conventional extracellular recording has revealed cross-modal alterations of auditory cell activities by cutaneous electrical stimulation of the hindpaw in first- and higher-order auditory thalamic nuclei (Donishi et al., 2011). Juxta-cellular recording and labeling techniques were used in the present study to examine the cross-modal alterations in detail, focusing on possible nucleus and/or cell type-related distinctions in modulation. Recordings were obtained from 80 cells of anesthetized rats. Cutaneous electrical stimulation, which did not elicit unit discharges, i.e., subthreshold effects, modulated early (onset) and/or late auditory responses of first- (64%) and higher-order nucleus cells (77%) with regard to response magnitude, latency and/or burst spiking. Attenuation predominated in the modulation of response magnitude and burst spiking, and delay predominated in the modulation of response time. Striking alterations of burst spiking took place in higher-order nucleus cells, which had the potential to exhibit higher propensities for burst spiking as compared to first-order nucleus cells. A subpopulation of first-order nucleus cells showing modulation in early response magnitude in the caudal domain of the nucleus had larger cell bodies and higher propensities for burst spiking as compared to cells showing no modulation. These findings suggest that somatosensory influence is incorporated into parallel channels in auditory thalamic nuclei to impose distinct impacts on cortical and subcortical sensory processing. Further, cutaneous electrical stimulation given after early auditory responses modulated late responses. Somatosensory influence is likely to affect ongoing auditory processing at any time without being coincident with sound onset in a narrow temporal window.

Touching lips and hearing fingers: effector-specific congruency between tactile and auditory stimulation modulates N1 amplitude and alpha desynchronization

Understanding the interactions between audition and sensorimotor processes is of theoretical importance, particularly in relation to speech processing. Although one current focus in this area is on interactions between auditory perception and the motor system, there has been less research on connections between the auditory and somatosensory modalities. The current study takes a novel approach to this omission by examining specific auditory-tactile interactions in the context of speech and non-speech sound production. Electroencephalography was used to examine brain responses when participants were presented with speech syllables (a bilabial sound /pa/ and a non-labial sound /ka/) or finger-snapping sounds that were simultaneously paired with tactile stimulation of either the lower lip or the right middle finger. Analyses focused on the sensory-evoked N1 in the event-related potential and the extent of alpha band desynchronization elicited by the stimuli. N1 amplitude over fronto-central sites was significantly enhanced when the bilabial /pa/ sound was paired with tactile lip stimulation and when the finger-snapping sound was paired with tactile stimulation of the finger. Post-stimulus alpha desynchronization at central sites was also enhanced when the /pa/ sound was accompanied by tactile stimulation of the lip. These novel findings indicate that neural aspects of somatosensory-auditory interactions are influenced by the congruency between the location of the bodily touch and the bodily origin of a perceived sound.

Connectional Modularity of Top-Down and Bottom-Up Multimodal Inputs to the Lateral Cortex of the Mouse Inferior Colliculus

The lateral cortex of the inferior colliculus receives information from both auditory and somatosensory structures and is thought to play a role in multisensory integration. Previous studies in the rat have shown that this nucleus contains a series of distinct anatomical modules that stain for GAD-67 as well as other neurochemical markers. In the present study, we sought to better characterize these modules in the mouse inferior colliculus and determine whether the connectivity of other neural structures with the lateral cortex is spatially related to the distribution of these neurochemical modules. Staining for GAD-67 and other markers revealed a single modular network throughout the rostrocaudal extent of the mouse lateral cortex. Somatosensory inputs from the somatosensory cortex and dorsal column nuclei were found to terminate almost exclusively within these modular zones. However, projections from the auditory cortex and central nucleus of the inferior colliculus formed patches that interdigitate with the GAD-67-positive modules. These results suggest that the lateral cortex of the mouse inferior colliculus exhibits connectional as well as neurochemical modularity and may contain multiple segregated processing streams. This finding is discussed in the context of other brain structures in which neuroanatomical and connectional modularity have functional consequences.

SIGNIFICANCE STATEMENT

Many brain regions contain subnuclear microarchitectures, such as the matrix-striosome organization of the basal ganglia or the patch-interpatch organization of the visual cortex, that shed light on circuit complexities. In the present study, we demonstrate the presence of one such micro-organization in the rodent inferior colliculus. While this structure is typically viewed as an auditory integration center, its lateral cortex appears to be involved in multisensory operations and receives input from somatosensory brain regions. We show here that the lateral cortex can be further subdivided into multiple processing streams: modular regions, which are targeted by somatosensory inputs, and extramodular zones that receive auditory information.

Muscarinic acetylcholine receptors control baseline activity and Hebbian stimulus timing-dependent plasticity in fusiform cells of the dorsal cochlear nucleus

Cholinergic modulation contributes to adaptive sensory processing by controlling spontaneous and stimulus-evoked neural activity and long-term synaptic plasticity. In the dorsal cochlear nucleus (DCN), in vitro activation of muscarinic acetylcholine receptors (mAChRs) alters the spontaneous activity of DCN neurons and interacts with N-methyl-d-aspartate (NMDA) and endocannabinoid receptors to modulate the plasticity of parallel fiber synapses onto fusiform cells by converting Hebbian long-term potentiation to anti-Hebbian long-term depression. Because noise exposure and tinnitus are known to increase spontaneous activity in fusiform cells as well as alter stimulus timing-dependent plasticity (StTDP), it is important to understand the contribution of mAChRs to in vivo spontaneous activity and plasticity in fusiform cells. In the present study, we blocked mAChRs actions by infusing atropine, a mAChR antagonist, into the DCN fusiform cell layer in normal hearing guinea pigs. Atropine delivery leads to decreased spontaneous firing rates and increased synchronization of fusiform cell spiking activity. Consistent with StTDP alterations observed in tinnitus animals, atropine infusion induced a dominant pattern of inversion of StTDP mean population learning rule from a Hebbian to an anti-Hebbian profile. Units preserving their initial Hebbian learning rules shifted toward more excitatory changes in StTDP, whereas units with initial suppressive learning rules transitioned toward a Hebbian profile. Together, these results implicate muscarinic cholinergic modulation as a factor in controlling in vivo fusiform cell baseline activity and plasticity, suggesting a central role in the maladaptive plasticity associated with tinnitus pathology.NEW & NOTEWORTHY This study is the first to use a novel method of atropine infusion directly into the fusiform cell layer of the dorsal cochlear nucleus coupled with simultaneous recordings of neural activity to clarify the contribution of muscarinic acetylcholine receptors (mAChRs) to in vivo fusiform cell baseline activity and auditory-somatosensory plasticity. We have determined that blocking the mAChRs increases the synchronization of spiking activity across the fusiform cell population and induces a dominant pattern of inversion in their stimulus timing-dependent plasticity. These modifications are consistent with similar changes established in previous tinnitus studies, suggesting that mAChRs might have a critical contribution in mediating the maladaptive alterations associated with tinnitus pathology. Blocking mAChRs also resulted in decreased fusiform cell spontaneous firing rates, which is in contrast with their tinnitus hyperactivity, suggesting that changes in the interactions between the cholinergic and GABAergic systems might also be an underlying factor in tinnitus pathology.

Maladaptive plasticity in tinnitus--triggers, mechanisms and treatment

Tinnitus is a phantom auditory sensation that reduces quality of life for millions of people worldwide, and for which there is no medical cure. Most cases of tinnitus are associated with hearing loss caused by ageing or noise exposure. Exposure to loud recreational sound is common among the young, and this group are at increasing risk of developing tinnitus. Head or neck injuries can also trigger the development of tinnitus, as altered somatosensory input can affect auditory pathways and lead to tinnitus or modulate its intensity. Emotional and attentional state could be involved in the development and maintenance of tinnitus via top-down mechanisms. Thus, military personnel in combat are particularly at risk owing to combined risk factors (hearing loss, somatosensory system disturbances and emotional stress). Animal model studies have identified tinnitus-associated neural changes that commence at the cochlear nucleus and extend to the auditory cortex and other brain regions. Maladaptive neural plasticity seems to underlie these changes: it results in increased spontaneous firing rates and synchrony among neurons in central auditory structures, possibly generating the phantom percept. This Review highlights the links between animal and human studies, and discusses several therapeutic approaches that have been developed to target the neuroplastic changes underlying tinnitus.

Music in Research and Rehabilitation of Disorders of Consciousness: Psychological and Neurophysiological Foundations

According to a prevailing view, the visual system works by dissecting stimuli into primitives, whereas the auditory system processes simple and complex stimuli with their corresponding features in parallel. This makes musical stimulation particularly suitable for patients with disorders of consciousness (DoC), because the processing pathways related to complex stimulus features can be preserved even when those related to simple features are no longer available. An additional factor speaking in favor of musical stimulation in DoC is the low efficiency of visual stimulation due to prevalent maladies of vision or gaze fixation in DoC patients. Hearing disorders, in contrast, are much less frequent in DoC, which allows us to use auditory stimulation at various levels of complexity. The current paper overviews empirical data concerning the four main domains of brain functioning in DoC patients that musical stimulation can address: perception (e.g., pitch, timbre, and harmony), cognition (e.g., musical syntax and meaning), emotions, and motor functions. Music can approach basic levels of patients' self-consciousness, which may even exist when all higher-level cognitions are lost, whereas music induced emotions and rhythmic stimulation can affect the dopaminergic reward-system and activity in the motor system respectively, thus serving as a starting point for rehabilitation.