40 Hz Auditory Steady-State Response: The Impact of Handedness and Gender

Sex differences and the effect of female sex hormones on auditory function: a systematic review

Aims

First, to discuss sex differences in auditory function between women and men, and whether cyclic fluctuations in levels of female sex hormones (i.e., estradiol and progesterone) affect auditory function in pre-menopausal and post-menopausal women. Second, to systematically review the literature concerning the discussed patterns in order to give an overview of the methodologies used in research. Last, to identify the gap in knowledge and to make recommendations for future work.

Methods for the systematic review

Population, Exposure, Control, Outcome and Study design (PECOS) criteria were used in developing the review questions. The review protocol follows the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and was pre-registered in the Prospective Register of Systematic Reviews (PROSPERO; CRD42020201480). Data Sources: EMBASE, PubMed, MEDLINE (Ovid), PsycINFO, ComDisDome, CINAHL, Web of Science, Cochrane Central Register of Controlled Trials (CENTRAL) via Cochrane Library, and scanning reference lists of relevant studies, and internet resources (i.e., Mendeley) were used. Only studies published between 1999 and 2022, in English, or in English translation, were included. The quality of evidence was assessed using the Newcastle-Ottawa Scale (NOS).

Results

Sex differences: Women had more sensitive hearing (measured at the level of peripheral and central auditory system) than men. Cyclic fluctuations: Auditory function in women fluctuated during the menstrual cycle, while no such fluctuations in men over the same time period were reported. Hearing sensitivity improved in women during the late follicular phase, and decrease during the luteal phase, implying an effect of female sex hormones, although the specific effects of estradiol and progesterone fluctuations on the central auditory system remain unclear. Hearing sensitivity in women declined rapidly at the onset of menopause.

Conclusion

The review has shown the following. Consistent sex differences exist in auditory function across the auditory pathway with pre-menopausal women often showing better function than age-matched men. Moreover, pre-menopausal women show fluctuations in hearing function across the menstrual cycle with a better function during the peak of estradiol or when the ratio of estradiol to progesterone is high. Third, menopause marks the onset of hearing loss in women, characterized by a rapid decline in hearing sensitivity and a more pronounced loss than in age-matched men. Finally, the systematic review highlights the need for well-designed and -controlled studies to evaluate the influence of estradiol and progesterone on hearing by consistently including control groups (e.g., age-matched man), using objective tests to measure hormonal levels (e.g., in saliva or blood), and by testing participants at different points across the menstrual cycle.

Systematic review registration

https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020201480, identifier CRD42020201480.

Effective networks mediate right hemispheric dominance of human 40 Hz auditory steady-state response

Auditory steady-state responses (ASSR) are induced from the brainstem to the neocortex when humans hear periodic amplitude-modulated tonal signals. ASSRs have been argued to be a key marker of auditory temporal processing and pathological reorganization of ASSR - a biomarker of neurodegenerative disorders. However, most of the earlier studies reporting the neural basis of ASSRs were focused on looking at individual brain regions. Here, we seek to characterize the large-scale directed information flow among cortical sources of ASSR entrained by 40 Hz external signals. Entrained brain rhythms with power peaking at 40 Hz were generated using both monaural and binaural tonal stimulation. First, we confirm the presence of ASSRs and their well-known right hemispheric dominance during binaural and both monaural conditions. Thereafter, reconstruction of source activity employing individual anatomy of the participant and subsequent network analysis revealed that while the sources are common among different stimulation conditions, differential levels of source activation and differential patterns of directed information flow using Granger causality among sources underlie processing of binaurally and monaurally presented tones. Particularly, we show bidirectional interactions involving the right superior temporal gyrus and inferior frontal gyrus underlie right hemispheric dominance of 40 Hz ASSR during both monaural and binaural conditions. On the other hand, for monaural conditions, the strength of inter-hemispheric flow from left primary auditory areas to right superior temporal areas followed a pattern that comply with the generally observed contralateral dominance of sensory signal processing.

Cortical connectomic mediations on gamma band synchronization in schizophrenia

Aberrant gamma frequency neural oscillations in schizophrenia have been well demonstrated using auditory steady-state responses (ASSR). However, the neural circuits underlying 40 Hz ASSR deficits in schizophrenia remain poorly understood. Sixty-six patients with schizophrenia spectrum disorders and 85 age- and gender-matched healthy controls completed one electroencephalography session measuring 40 Hz ASSR and one imaging session for resting-state functional connectivity (rsFC) assessments. The associations between the normalized power of 40 Hz ASSR and rsFC were assessed via linear regression and mediation models. We found that rsFC among auditory, precentral, postcentral, and prefrontal cortices were positively associated with 40 Hz ASSR in patients and controls separately and in the combined sample. The mediation analysis further confirmed that the deficit of gamma band ASSR in schizophrenia was nearly fully mediated by three of the rsFC circuits between right superior temporal gyrus-left medial prefrontal cortex (MPFC), left MPFC-left postcentral gyrus (PoG), and left precentral gyrus-right PoG. Gamma-band ASSR deficits in schizophrenia may be associated with deficient circuitry level connectivity to support gamma frequency synchronization. Correcting gamma band deficits in schizophrenia may require corrective interventions to normalize these aberrant networks.

Synchronized Auditory Gamma Response to Frontal Transcranial Direct Current Stimulation (tDCS) and its Inter-Individual Variation in Healthy Humans

In schizophrenia, a disorder associated with N-methyl-D-aspartate receptor (NMDAR) hypofunction, auditory cortical plasticity deficits have been indexed by the synchronized electroencephalographic (EEG) auditory steady-state gamma-band (40-Hz) response (ASSR) and the early auditory evoked gamma-band response (aeGBR), both considered to be target engagement biomarkers for NMDAR function, and potentially amenable to treatment by NMDAR modulators. As transcranial direct current stimulation (tDCS) is likely dependent on NMDAR neurotransmission, this preliminary study, conducted in 30 healthy volunteers, assessed the off-line effects of prefrontal anodal tDCS and sham (placebo) treatment on 40-Hz ASSR and aeGBR. Anodal tDCS failed to alter aeGBR but increased both 40-Hz ASSR power, as measured by event-related spectral perturbations (ERSP), and phase locking, as measured by inter-trial phase consistency (ITPC). Inter-individual differences in tDCS-induced increases in ERSP were negatively related to baseline ERSPs. These findings provide tentative support for further study of tDCS as a potential NMDAR neuromodulatory intervention for synchronized auditory gamma response deficits.

Characteristics of auditory steady-state responses to different click frequencies in awake intact macaques

Background

Auditory steady-state responses (ASSRs) are periodic evoked responses to constant periodic auditory stimuli, such as click trains, and are suggested to be associated with higher cognitive functions in humans. Since ASSRs are disturbed in human psychiatric disorders, recording ASSRs from awake intact macaques would be beneficial to translational research as well as an understanding of human brain function and its pathology. However, ASSR has not been reported in awake macaques.

Results

Electroencephalograms (EEGs) were recorded from awake intact macaques, while click trains at 20–83.3 Hz were binaurally presented. EEGs were quantified based on event-related spectral perturbation (ERSP) and inter-trial coherence (ITC), and ASSRs were significantly demonstrated in terms of ERSP and ITC in awake intact macaques. A comparison of ASSRs among different click train frequencies indicated that ASSRs were maximal at 83.3 Hz. Furthermore, analyses of laterality indices of ASSRs showed that no laterality dominance of ASSRs was observed.

Conclusions

The present results demonstrated ASSRs, comparable to those in humans, in awake intact macaques. However, there were some differences in ASSRs between macaques and humans: macaques showed maximal ASSR responses to click frequencies higher than 40 Hz that has been reported to elicit maximal responses in humans, and showed no dominant laterality of ASSRs under the electrode montage in this study compared with humans with right hemisphere dominance. The future ASSR studies using awake intact macaques should be aware of these differences, and possible factors, to which these differences were ascribed, are discussed.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12868-022-00741-9.

Spinal and Cerebral Integration of Noxious Inputs in Left-handed Individuals

Some pain-related information is processed preferentially in the right cerebral hemisphere. Considering that functional lateralization can be affected by handedness, spinal and cerebral pain-related responses may be different between right- and left-handed individuals. Therefore, this study aimed to investigate the cortical and spinal mechanisms of nociceptive integration when nociceptive stimuli are applied to right -handed vs. left -handed individuals. The NFR, evoked potentials (ERP: P45, N100, P260), and event-related spectral perturbations (ERSP: theta, alpha, beta and gamma band oscillations) were compared between ten right-handed and ten left-handed participants. Pain was induced by transcutaneous electrical stimulation of the lower limbs and left upper limb. Stimulation intensity was adjusted individually in five counterbalanced conditions of 21 stimuli each: three unilateral (right lower limb, left lower limb, and left upper limb stimulation) and two bilateral conditions (right and left lower limbs, and the right lower limb and left upper limb stimulation). The amplitude of the NFR, ERP, ERSP, and pain ratings were compared between groups and conditions using a mixed ANOVA. A significant increase of responses was observed in bilateral compared with unilateral conditions for pain intensity, NFR amplitude, N100, theta oscillations, and gamma oscillations. However, these effects were not significantly different between right- and left-handed individuals. These results suggest that spinal and cerebral integration of bilateral nociceptive inputs is similar between right- and left-handed individuals. They also imply that pain-related responses measured in this study may be examined independently of handedness.

Gamma-Range Auditory Steady-State Responses and Cognitive Performance: A Systematic Review

The auditory steady-state response (ASSR) is a result of entrainment of the brain's oscillatory activity to the frequency and phase of temporally modulated stimuli. Gamma-range ASSRs are utilized to observe the dysfunctions of brain-synchronization abilities in neuropsychiatric and developmental disorders with cognitive symptoms. However, the link between gamma-range ASSRs and cognitive functioning is not clear. We systematically reviewed existing findings on the associations between gamma-range ASSRs and cognitive functions in patients with neuropsychiatric or developmental disorders and healthy subjects. The literature search yielded 1597 articles. After excluding duplicates and assessing eligibility, 22 articles were included. In healthy participants, the gamma-range ASSR was related to cognitive flexibility and reasoning as measured by complex tasks and behavioral indicators of processing speed. In patients with schizophrenia, the studies that reported correlations found a higher ASSR to be accompanied by better performance on short-term memory tasks, long-term/semantic memory, and simple speeded tasks. The main findings indicate that individual differences in the gamma-range ASSR reflect the level of attentional control and the ability to temporary store and manipulate the information, which are necessary for a wide range of complex cognitive activities, including language, in both healthy and impaired populations.

Tactile Cross-Modal Acceleration Effects on Auditory Steady-State Response

In the sensory cortex, cross-modal interaction occurs during the early cortical stages of processing; however, its effect on the speed of neuronal activity remains unclear. In this study, we used magnetoencephalography (MEG) to investigate whether tactile stimulation influences auditory steady-state responses (ASSRs). To this end, a 0.5-ms electrical pulse was randomly presented to the dorsum of the left or right hand of 12 healthy volunteers at 700 ms while a train of 25-ms pure tones were applied to the left or right side at 75 dB for 1,200 ms. Peak latencies of 40-Hz ASSR were measured. Our results indicated that tactile stimulation significantly shortened subsequent ASSR latency. This cross-modal effect was observed from approximately 50 ms to 125 ms after the onset of tactile stimulation. The somatosensory information that appeared to converge on the auditory system may have arisen during the early processing stages, with the reduced ASSR latency indicating that a new sensory event from the cross-modal inputs served to increase the speed of ongoing sensory processing. Collectively, our findings indicate that ASSR latency changes are a sensitive index of accelerated processing.

40-Hz auditory steady-state responses and the complex information processing: An exploratory study in healthy young males

Electroencephalographic (EEG) activity in the gamma (30–80 Hz) range is related to a variety of sensory and cognitive processes which are frequently impaired in schizophrenia. Auditory steady-state response at 40-Hz (40-Hz ASSR) is utilized as an index of gamma activity and is proposed as a biomarker of schizophrenia. Nevertheless, the link between ASSRs and cognitive functions is not clear. This study explores a possible relationship between the performance on cognitive tasks and the 40-Hz ASSRs in a controlled uniform sample of young healthy males, as age and sex may have complex influence on ASSRs. Twenty-eight young healthy male volunteers participated (mean age ± SD 25.8±3.3) in the study. The 40-Hz click trains (500 ms) were presented 150 times with an inter-stimulus interval set at 700–1000 ms. The phase-locking index (PLI) and event-related power perturbation (ERSP) of the ASSR were calculated in the 200–500 ms latency range, which corresponds to the steady part of the response. The Psychology Experiment Building Language (PEBL) task battery was used to assess five cognitive subdomains: the Choice response time task, the Stroop test, the Tower of London test, the Lexical decision task and the Semantic categorisation task. Pearson‘s correlation coefficients were calculated to access the relationships; no multiple-test correction was applied as the tests were explorative in nature. A significant positive correlation was observed for the late-latency gamma and the mean number of steps in the Tower of London task reflecting planning and problem-solving abilities. These findings support the concept that 40-Hz ASSR might highlight top-down mechanisms which are related to cognitive functioning. Therefore, 40-Hz ASSRs can be used to explore the relationship between cognitive functioning and neurophysiological indices of brain activity.

Cortical volume and 40-Hz auditory-steady-state responses in patients with schizophrenia and healthy controls

Background

Abnormalities in the 40-Hz auditory steady-state response (ASSR) of the gamma range have been reported in schizophrenia (SZ) and are regarded as important pathophysiological features. Many of the previous studies reported diminished gamma oscillations in SZ, although some studies reported increased spontaneous gamma oscillations. Furthermore, brain morphological correlates of the gamma band ASSR deficits have rarely examined. We investigated different measures of the 40-Hz ASSR and their association with brain volumes and psychological measures of SZ.

Methods

The 40-Hz ASSR was measured for 80 dB click sounds (1 ms, 500-ms trains at 40-Hz, with 3050 to 3500 inter-train interval) using electroencephalography with 64 electrodes in 33 patients with SZ (male: 16, female: 17 (age range: 21–60)) and 30 healthy controls (HCs) (male: 13, female: 17 (age range: 23–64)). Four gamma oscillation measures (evoked power, spontaneous oscillations (baseline and total power), and inter-trial phase coherence (ITC)) were assessed. The source activities of the ASSR were also analyzed. Brain volumes were assessed using high-resolution magnetic resonance imaging and voxel-based morphometry and superior temporal gyrus (STG) volume measures were obtained.

Results

Patients with SZ had larger total and evoked powers and higher ITC than HCs. Both groups showed significantly different association between mean evoked power and right STG volume. In HCs but not SZ, mean evoked power showed significant positive correlation with right STG volume. In addition, the two groups showed significantly different association between verbal fluency and mean evoked power. High evoked power was significantly correlated with poor verbal fluency in SZ.

Conclusions

The current study found increased gamma oscillation in SZ and suggests significant involvement of the STG in gamma oscillations.

•

SZ had larger total and evoked powers and higher ITC than HCs.

•

Evoked power positively correlated with right STG volume in HCs.

•

High evoked power correlated with poor verbal fluency in SZ.

Enhanced Auditory Steady-State Response Using an Optimized Chirp Stimulus-Evoked Paradigm

Objectives: It has been reported recently that gamma measures of the electroencephalogram (EEG) might provide information about the candidate biomarker of mental diseases like schizophrenia, Alzheimer's disease, affective disorder and so on, but as we know it is a difficult issue to induce visual and tactile evoked responses at high frequencies. Although a high-frequency response evoked by auditory senses is achievable, the quality of the recording response is not ideal, such as relatively low signal-to-noise ratio (SNR). Recently, auditory steady-state responses (ASSRs) play an essential role in the field of basic auditory studies and clinical uses. However, how to improve the quality of ASSRs is still a challenge which researchers have been working on. This study aims at designing a more comfortable and suitable evoked paradigm and then enhancing the quality of the ASSRs in healthy subjects so as to further apply it in clinical practice. Methods: Chirp and click stimuli with 40 Hz and 60 Hz were employed to evoke the gamma-ASSR respectively, and the sound adjusted to 45 dB sound pressure level (SPL). Twenty healthy subjects with normal-hearing participated, and 64-channel EEGs were simultaneously recorded during the experiment. Event-related spectral perturbation (ERSP) and SNR of the ASSRs were measured and analyzed to verify the feasibility and adaptability of the proposed evoked paradigm. Results: The results showed that the evoked paradigm proposed in this study could enhance ASSRs with strong feasibility and adaptability. 1) ASSR waves in time domain indicated that 40 Hz stimuli could significantly induce larger peak-to-peak values of ASSRs compared to 60 Hz stimuli (p < 0.01**); ERSP showed that obvious ASSRs were obtained at each lead for both 40 Hz and 60 Hz, as well as the click and chirp stimuli. 2) The SNR of the ASSRs were ⁻3.23 ± 1.68, ⁻2.44 ± 2.90, ⁻4.66 ± 2.09, and ⁻3.53 ± 3.49 respectively for 40 Hz click, 40 Hz chirp, 60 Hz click and 60 Hz chirp, indicating the chirp stimuli could induce significantly better ASSR than the click, and 40 Hz ASSRs had the higher SNR than 60 Hz (p < 0.01**). Limitation: In this study, sample size was small and the age span was not large enough. Conclusions: This study verified the feasibility and adaptability of the proposed evoked paradigm to improve the quality of the gamma-ASSR, which is significant in clinical application. The results suggested that 40 Hz ASSR evoked by chirp stimuli had the best performance and was expected to be used in clinical practice, especially in the field of mental diseases such as schizophrenia, Alzheimer's disease, and affective disorder.

Effects of degree and symmetricity of bilateral spectral smearing, carrier frequency, and subject sex on amplitude of evoked auditory steady-state response signal

The characteristics of an auditory steady-state response (ASSR) signal can be affected by the pathophysiological statuses of the left and right ears, such as a smeared sensation by native spectral smearing owing to sensorineural hearing impairment, because they can affect the perception of the stimulus, the degree of concentration on the stimulus and comfort in concentration. However, to date, few studies have examined the effects of such smeared sensations on the amplitude of the evoked ASSR signal. In this study, we synthesized various auditory stimuli with different degrees of spectral smearing using a hearing loss simulator to match the age of participant groups with different degrees of spectral smearing. We then performed three subjective tests, representing symmetric and asymmetric bilateral spectral smearing, with 16 normal-hearing individuals to observe the effects of the severity and symmetricity of bilateral spectral smearing, the value of the carrier frequency of auditory stimuli, and the sex of the individual on the amplitude in evoked ASSR signals. The experimental results demonstrated the following: (1) the application of spectral smearing to normal sounds may result in amplitude-reduced ASSR signals, (2) the effect of spectral smearing on the amplitude of the ASSR signals is most significant when the degrees of bilateral spectral smearing are asymmetric, (3) the selection of carrier frequency in an auditory stimulus can affect the amplitude of evoked ASSR signals regardless of the degree of spectral smearing, and (4) the sex of the individual can affect the amplitude of the evoked ASSR signal in various test conditions. The results of this study can help estimate the effects of smeared sensation by spectral smearing owing to sensorineural hearing impairment on the amplitude of evoked ASSR signals.