Electrically-evoked responses in animals with progressive spiral ganglion degeneration

TMC function in hair cell transduction

Transmembrane channel-like (TMC) proteins 1 and 2 are necessary for hair cell mechanotransduction but their precise function is controversial. A growing body of evidence supports a direct role for TMC1 and TMC2 as components of the transduction complex. However, a number of important questions remain and alternate hypotheses have been proposed. Here we present an historical overview of the identification and cloning of Tmc genes, a discussion of mutations in TMC1 that cause deafness in mice and humans and a brief review of other members of the Tmc gene superfamily. We also examine expression of Tmc mRNAs and localization of the protein products. The review focuses on potential functions of TMC proteins and the evidence from Beethoven mice that suggests a direct role for TMC1 in hair cell mechanotransduction. Data that support alternate interpretations are also considered. The article concludes with a discussion of outstanding questions and future directions for TMC research. This article is part of a Special Issue entitled <Annual Reviews 2014>.

Sheep as a large animal model for middle and inner ear implantable hearing devices: a feasibility study in cadavers

OBJECTIVE

Currently, no large animal model exists for surgical-experimental exploratory analysis of implantable hearing devices. In a histomorphometric study, we sought to investigate whether sheep or pig cochleae are suitable for this purpose and whether device implantation is feasible.

METHODS

Skulls of pig and sheep cadavers were examined using high-resolution 128-slice computed tomography (CT) to study anatomic relationships. A cochlear implant and an active middle ear implant could be successfully implanted into the sheep's inner and middle ear, respectively. Correct device placement was verified by CT and histology. The cochlear anatomy of the sheep was further studied by micro-CT and histology.

RESULTS

Our investigations indicate that the sheep is a suitable animal model for implantation of implantable hearing devices. The implantation of the devices was successfully performed by access through a mastoidectomy. The histologic, morphologic, and micro-CT study of the sheep cochlea showed that it is highly similar to the human cochlea. The temporal bone of the pig was not suitable for these microsurgical procedures because the middle and inner ear were not accessible owing to distinct soft and fatty tissue coverage of the mastoid.

CONCLUSION

The sheep is an appropriate large animal model for experimental studies with implantable hearing devices, whereas the pig is not.

Bilateral cochlear implantation in the ferret: a novel animal model for behavioral studies

Bilateral cochlear implantation has recently been introduced with the aim of improving both speech perception in background noise and sound localization. Although evidence suggests that binaural perception is possible with two cochlear implants, results in humans are variable. To explore potential contributing factors to these variable outcomes, we have developed a behavioral animal model of bilateral cochlear implantation in a novel species, the ferret. Although ferrets are ideally suited to psychophysical and physiological assessments of binaural hearing, cochlear implantation has not been previously described in this species. This paper describes the techniques of deafening with aminoglycoside administration, surgical implantation of an intracochlear array and chronic intracochlear electrical stimulation with monitoring for electrode integrity and efficacy of stimulation. Experiments have been presented elsewhere to show that the model can be used to study behavioral and electrophysiological measures of binaural hearing in chronically implanted animals. This paper demonstrates that cochlear implantation and chronic intracochlear electrical stimulation are both safe and effective in ferrets, opening up the possibility of using this model to study potential protective effects of bilateral cochlear implantation on the developing central auditory pathway. Since ferrets can be used to assess psychophysical and physiological aspects of hearing along with the structure of the auditory pathway in the same animals, we anticipate that this model will help develop novel neuroprosthetic therapies for use in humans.

Neurotrophins and electrical stimulation for protection and repair of spiral ganglion neurons following sensorineural hearing loss

Exogenous neurotrophins (NTs) have been shown to rescue spiral ganglion neurons (SGNs) from degeneration following a sensorineural hearing loss (SNHL). Furthermore, chronic electrical stimulation (ES) has been shown to retard SGN degeneration in some studies but not others. Since there is evidence of even greater SGN rescue when NT administration is combined with ES, we examined whether chronic ES can maintain SGN survival long after cessation of NT delivery. Young adult guinea pigs were profoundly deafened using ototoxic drugs; five days later they were unilaterally implanted with an electrode array and drug delivery system. Brain derived neurotrophic factor (BDNF) was continuously delivered to the scala tympani over a four week period while the animal simultaneously received ES via bipolar electrodes in the basal turn (i.e., turn 1) scala tympani. One cohort (n=5) received ES for six weeks (i.e., including a two week period after the cessation of BDNF delivery; ES(6)); a second cohort (n=5) received ES for 10 weeks (i.e., a six week period following cessation of BDNF delivery; ES(10)). The cochleae were harvested for histology and SGN density determined for each cochlear turn for comparison with normal hearing controls (n=4). The withdrawal of BDNF resulted in a rapid loss of SGNs in turns 2-4 of the deafened/BDNF-treated cochleae; this was significant as early as two weeks following removal of the NT when compared with normal controls (p<0.05). Importantly, there was not a significant reduction in SGNs in turn 1 (i.e., adjacent to the electrode array) two and six weeks after NT removal, as compared with normal controls. This result suggests that chronic ES can prevent the rapid loss of SGNs that occurs after the withdrawal of exogenous NTs. Implications for the clinical delivery of NTs are discussed.

The role of PKCzeta in amikacin-induced apoptosis in the cochlea: prevention by aspirin

Aminoglycoside antibiotics are ototoxic, inducing irreversible sensorineural hearing loss mediated by oxidative and excitotoxic stresses. The NF-kappaB pathway is involved in the response to aminoglycoside damage in the cochlea. However, the molecular mechanisms of this ototoxicity remain unclear. We investigated the expression of PKCzeta, a key regulator of NF-kappaB activation, in response to aminoglycoside treatment. Amikacin induced PKCzeta cleavage and nuclear translocation. These events were concomitant with chromatin condensation and paralleled the decrease in NF-kappaB (p65) levels in the nucleus. Amikacin also induced the nuclear translocation of apoptotic inducing factor (AIF). Prior treatment with aspirin prevented PKCzeta cleavage and nuclear translocation. Thus, aspirin counteracts the early effects of amikacin, thereby protecting hair cells and spiral ganglion neurons. These results demonstrate that PKCzeta acts as sentinel connecting specific survival pathways to mediate cellular responses to amikacin ototoxicity.

Cochlear implantation in rats: a new surgical approach

The laboratory rat has been used extensively in auditory research but has had limited use in cochlear implant related research due mainly to the surgically restricted access to the scala tympani. We have developed a new surgical method for cochlear implantation in rats. The key to this protocol was cauterizing the stapedial artery (SA) and making a small cochleostomy near the round window in order to enlarge the surgical access to the scala tympani. Five normal hearing Hooded Wistar rats were used to investigate the effect of cauterizing the SA on hearing and auditory nerve survival. Results showed that cauterizing the SA was surgically feasible, afforded excellent exposure of the round window niche for cochleostomy, and did not adversely affect acoustic thresholds measured electrophysiologically. Moreover, there was no difference in spiral ganglion cell densities for any cochlear turn when compared with the contralateral control ears. Three deafened rats were subsequently implanted with a scala tympani electrode array using this new surgical approach. Electrically evoked auditory brainstem responses using bipolar stimulation, and subsequent cochlear histopathology demonstrated that cochlear implantation using a custom-made rat electrode array was safe and effective. The surgical approach presented in this paper presents a safe and effective procedure for acute or chronic cochlear implantation in the rat model.

Long-term sensorineural hearing loss induces functional changes in the rat auditory nerve

Loss of cochlear hair cells in the rat initiates degenerative change within the primary auditory neurons (ANs) of the cochlea. These degenerative changes include loss of peripheral processes, demyelination and ultimately cell death. This pathology will affect the biophysical processes involved in action potential generation and propagation to an electrical stimulus via a cochlear implant. We measured the response properties of ANs, with particular reference to their refractory behaviour, in normal, short- (9 weeks) and long-term (> 52 weeks) deafened rats. AN loss was moderate in the short-term and severe in the long-term deafened animals. AN activity was elicited using a brief electrical stimulus delivered via a bipolar electrode array implanted into the cochlea. The general response properties of ANs recorded from deafened cochleae were similar to those observed in normal cochleae, i.e. a monotonic increase in the probability of firing and a decrease in response latency and temporal jitter with increasing stimulus intensity. However, the absolute refractory period was significantly prolonged in animals deaf for > 12 months (P = 0.0026). Deafened animals also exhibited a highly significant increase in threshold compared with normal controls (P < 0.001). These functional changes have implications for recipients of cochlear implants and potential therapies directed toward halting or reversing AN pathology.

Neurophysiology of cochlear implant users II: comparison among speech perception, dynamic range, and physiological measures

OBJECTIVE

The overall objective of this study was to relate electrically evoked potentials recorded from different levels of the auditory pathway with behavioral measures obtained from adult cochlear implant subjects. The hypothesis was that adult recipients of cochlear implants who have open-set speech perception and those recipients with no open-set speech perception would differ in their neurophysiologic responses recorded at one or more levels of the auditory pathway.

DESIGN

The subjects were 11 adults implanted with the Clarion cochlear implant. The electrical auditory brainstem response (EABR, Wave V), electrical auditory middle latency response (EAMLR, Na-Pa complex), and the electrical late auditory response (ELAR, N1-P2 complex), were recorded from three intra-cochlear electrodes. The stimuli used to record the evoked potentials varied in rate and amplitude. Behavioral measures (between threshold and upper limit of comfortable loudness) were used to define the subject's dynamic range at the different stimulus rates. Word and sentence recognition tests evaluated subjects' speech perception in quiet and noise. Evoked potential and behavioral measures were examined for statistical significance using analysis of variance for repeated measures and correlational analyses.

RESULTS

Subjects without open-set speech recognition demonstrated 1) poorly formed or absent evoked potential responses, 2) reduced behavioral dynamic ranges, 3) lack of change in the size of the dynamic range with a change in stimulus rate, and 4) longer periods of auditory deprivation. The variables that differentiated the best performers included 1) presence of responses at all three levels of the auditory pathway, with large normalized amplitudes for the EAMLR, 2) lower evoked potential thresholds for the Na-Pa complex, 3) relatively large dynamic ranges, and 4) changes in the size of the dynamic range with changes in stimulus rate.

CONCLUSIONS

In this study, the inability to follow changes in the temporal characteristics of the stimulus was associated with poor speech perception performance. Results also illustrate that variability in speech perception scores of cochlear implant recipients relates to neurophysiologic responses at higher cortical levels of the auditory pathway. Presumably, limited neural synchrony for elicitation of electrophysiologic responses underlies limited speech perception. Results confirm that neural encoding with electrical stimulation must provide sufficient physiologic responses of the central nervous system to perceive speech through a cochlear implant.

Expression of NMDA, AMPA and GABA(A) receptor subunit mRNAs in the rat auditory brainstem. II. Influence of intracochlear electrical stimulation

We investigated the effects of intracochlear electrical stimulation (ICES) on auditory pathways of neonatal rat deafened by daily amikacin injections. Expression of mRNAs encoding ionotropic glutamate receptor subunits such as alpha-amino-3-hydroxy-5-methyl-4-isoxazole (AMPA) and N-methyl-D-aspartate (NMDA), and gamma-aminobutyric acid type A (GABA(A)) receptor subunits was assessed by in situ hybridization in the dorsal (DCN) and the ventral cochlear nucleus (VCN) and in the central nucleus of the inferior colliculus (CNIC). After 15 days of daily unilateral ICES, the expressions of NR1, NR2b and NR2c subunits of NMDA receptor, that of GluRA, B, C, D flop isoforms of AMPA receptor and that of some GABA(A) subunits (alpha1, beta1, gamma1, gamma2) were increased bilaterally in the DCN, VCN and the CNIC. These changes last over a week after stimulation for only NR1 and NR2c. These modifications might be related to long lasting synaptic plasticity of brainstem auditory pathways. As far as analogy to deaf children can be made, early electrical stimulation might be of interest to maintain neuronal networks.

Quantitative measures reflect degeneration, but not regeneration, in the deafness mouse organ of Corti

The deafness mouse (dn/dn) is a well known model of hereditary deafness uncomplicated by behavioral and motor disturbances. The organ of Corti in this mouse develops a normal complement of sensory and supporting cell structures, yet animals homozygous for this gene never demonstrate any hearing capacity. They are profoundly deaf from birth. Soon after development, the organ of Corti rapidly degenerates, most sensory cells having vanished by 50 days of age. Published observations have suggested that apical regions of the organ of Corti may regenerate some supporting cell structures by 90 days of age. We have quantified changes in organ of Corti structure from 15 to 130 days of age using several different measures. Measures of peak height and total cross-sectional area. as well as a subjective rating scale, all demonstrate consistent degenerative changes during this time period. No evidence for regeneration of supporting or sensory cell structures is noted, although a surprising degree of variability is present in all regions of the organ of Corti which may account for previous claims.

Functional responses from guinea pigs with cochlear implants. II. Changes in electrophysiological and psychophysical measures over time

This study, the second of a two-part investigation, assessed changes over time in functional measures of the electrically stimulated auditory system following ototoxic deafening. Guinea pigs were trained to respond behaviorally to threshold level acoustic stimuli and then unilaterally deafened and implanted with a bipolar pair of electrodes within the cochlea and a single extracochlear electrode. Using pulsatile stimuli, thresholds for the electrically evoked auditory brainstem response (EABR) and psychophysical detection were repeatedly collected from the same animals over 3-month post-implantation periods. Thresholds were obtained as a function of stimulus phase duration primarily using bipolar intracochlear stimulation. As in earlier studies, the threshold measures exhibited both intra- and intersubject variability. Analysis of group data failed to show any statistically significant changes over time in either EABR or psychophysical threshold at any fixed pulse duration. However, significant changes over time were found in the slopes of the strength-duration functions for both measures. Slopes became shallower with time, suggesting a reduction in the efficiency of stimulus current integration, a trend presumed to occur with neural degeneration. This result suggests that strength-duration functions could be useful as a clinical diagnostic measure.

Specificity of VIIIth nerve regeneration in lower vertebrates

From the initial studies of Sperry (Am. J. Physiol, 144:735-741, 1945) to more recent investigations, the regenerative capacity of the VIIIth cranial nerve in nonmammalian vertebrates has been noted for its robust and accurate recovery of functional connections after transection. The VIIIth cranial nerve contains nerve fibers that link functionally distinct sensory epithelial to various areas within the central nervous system (CNS), yet after transection these multiple components of the nerve navigate back to their original central target areas, without innervating inappropriate nuclei. A number of factors may be required to establish and direct VIIIth nerve regeneration. Cellular interactions appear to be necessary for the initiation of outgrowth and the maintenance of neural connections. The release of chemotropic substances from target cells has been postulated as the most likely mechanism guiding the reinnervation of central targets. Furthermore, the growth characteristics of these neurons in tissue culture, without target cells present, indicates that intrinsically regulated growth features may also contribute to the process of VIIIth nerve regeneration.

Intracochlear potential distribution with intracochlear and extracochlear electrical stimulation in humans

Intracochlear potential distributions were measured from subjects implanted with the Ineraid multichannel cochlear implant. The electrode array provided direct accessibility for obtaining measurements. Different modes of stimulation were used. The findings with intracochlear monopolar stimulation seem to confirm that significant low-resistance pathways, in which currents can flow into or out of the cochlea, are located in the basal turn. The results with extracochlear stimulation only show small intracochlear potential gradients. This finding suggests that no substantial currents flow along the auditory nerve fibers when extracochlear stimulation is used. These results concur with the electrically evoked auditory brain stem responses, in that intracochlear stimulation consistently elicited auditory brain stem responses, whereas responses elicited at or near the round window by extracochlear stimulation were weak or absent.

Ganglion cell loss continues during hair cell regeneration

Hair cells and ganglion cells were counted in young adult quail (Coturnix coturnix) after acoustic trauma at 10, 30, 60 and 90 day survival times. Following sacrifice the basilar papillae, along with the ganglia, were fixed, embedded in plastic and sectioned serially at 100 mu intervals from basal to apical tip. Hair cells and ganglion cells were counted from 3 mu thick sections at each interval. Hair cells were designated as tall or short within the area 30-70% of length from basal tip of the papilla. Both tall and short hair cells were significantly reduced in number 10 days following trauma. Tall hair cells recovered to within 96% of normal after 60-90 days. Short hair cells recovered but to a lesser extent. Ganglion cell loss did not begin until 30 days after trauma and continued without recovery 90 days after trauma. A good correlation was found for position of both types of hair cell loss and position of ganglion cell loss. These results suggest that the initial loss of hair cells, both tall and short, results in retrograde degeneration of neural fibers and ganglion cells.

Evaluation of eighth nerve integrity by the electrically evoked middle latency response

A reliable objective test for estimating the number and distribution of surviving eighth nerve fibers needs to be identified for selection of candidates for cochlear implantation. Kanamycin and ethacrynic acid administration in guinea pigs resulted in graded amounts of eighth nerve degeneration over time. The electrically-induced middle latency response (EMLR) was acutely recorded in these animals at specific post-drug times, followed by the immediate killing of the animals, histologic preparation, and spiral ganglion cell density determination. Significant progressive spiral ganglion cell loss was noted by 4 weeks that increased over time. While EMLR threshold remained stable over time, the slope of the EMLR input/output function decreased with increasing post-drug intervals in a manner directly correlated with reduction in spiral ganglion cell density.

Cochlear ablation in deafness mutant mice: 2-deoxyglucose analysis suggests no spontaneous activity of cochlear origin

Deafness mutant mice show no stimulus-related cochlear potentials as well as abnormal electrically-evoked responses recorded from the inferior colliculus. Abnormal spontaneous activity in the auditory periphery could result in abnormal development and/or maintenance of the central auditory pathways. We therefore assessed spontaneous activity of cochlear origin in the central nuclei of the mutants by ablating one cochlea and subsequently using the 2-deoxyglucose (2DG) technique to study metabolic activity. Any asymmetries in labeling in a given nucleus should be due to spontaneous activity in the cochlear nerve on the unoperated side. In control animals (+/dn mice undergoing unilateral cochlea ablation), statistically significant decreased 2DG labeling was observed in the ipsilateral PVCN and AVCN, and contralateral MNTB and IC; all receive primary excitatory input from the ablated ear. No significant differences in labeling between right and left sides were observed in any of the nuclei studied in the mutant animals. These findings suggest that there is no spontaneous activity of cochlear origin in these mutants, even though many cochlear nerve fibers and spiral ganglion cells survive.

Electrophysiology of the auditory system

This review has attempted to summarise the properties of electro physiological responses in the auditory system. The treatment was broad and consequently somewhat sketchy. For a more detailed recent treatment of the physiology of the auditory system the reader is referred to Pickles (1982), Møller (1983), or Altschuller et al (1986). The data on acoustic injury have been reviewed recently by Schmiedt (1984). Discussions of a number of topics such as development, hair cell function and speech encoding are found in Berlin (1984).

Characterization of the electrically evoked auditory brainstem response (ABR) in cats and humans

Electrically evoked auditory brainstem response (EABR) recordings were made from 38 humans implanted with one of three cochlear prostheses, and from 25 cats. Recognizable auditory potentials were identified in 27 of the profoundly deaf implanted subjects. In both cats and humans EABR waveform morphology and magnitude were independent of electrode configuration and paralleled those of the normal acoustic ABR, but with reduced absolute latencies. EABR recordings are highly susceptible to contamination by stimulus artifact and by elicited non-auditory potentials. Latency, morphology, and magnitude criteria are proposed for identification and analysis of EABR components.

Electrical stimulation of the auditory system in animals profoundly deaf from birth

Animals homozygous for the recessive deafness gene (dn/dn) have been used to study central responses to modiolar or round window electrical stimulation. Inferior colliculus evoked responses to contralateral constant current pulses are larger in mutants than in controls. In mutants, responses are largest in animals aged 5-7 months, compared with animals aged 42-50 days or 13.5-19 months. The spiral ganglion cell density is normal in the youngest group, but decreases significantly in older animals. Electrical stimulation of the round window is less effective than modiolar stimulation. Single unit recordings suggest that the larger evoked responses in deafness mice are produced by stronger discharges in neurones, rather than greater synchrony of discharge. The deafness mutation appears to provide a useful animal model for studying electrical stimulation of a central pathway which has never received stimulus-related input.

Genetic factors affecting hearing development

Both genetic background and single gene mutations may affect the development of the auditory system. A classification system is presented for those single gene mutations causing hearing impairment. The new feature of this classification is the inclusion of a category for hereditary deafness of central origin. The other categories involve peripheral abnormalities and are: morphogenetic defects, in which the overall structure of the labyrinth is deformed; neuroepithelial degeneration, in which the primary defect appears to occur in the organ of Corti; and cochleo-saccular degeneration, where the stria vascularis is abnormal and Reissner's membrane collapses, leading to further degeneration.

Inferior colliculus single unit responses to peripheral electrical stimulation in normal and congenitally deaf mice

We have investigated the single unit response in the inferior colliculus of the mouse to electrical pulse stimulation at the auditory periphery. The experimental animals were deafness mutant mice (dn/dn), which have hereditary congenital peripheral pathology. The control animals were normal littermates (+/dn). Monopolar electrical pulses were applied either to the modiolus or the round window and the evoked single unit activity was recorded in the contralateral inferior colliculus (IC). Two types of single unit response were observed: a single-spike response, and a multiple-spike response. There was a predominance of the former in the control animals and of the latter in the mutants. For both modes of stimulation the group mean threshold of response was lower in mutants compared to controls, whilst the maximum number of evoked spikes per 50 presentations was higher in mutants than control animals. The mutant response pattern was similar to that seen in animals with experimentally induced auditory deprivation. The suitability of the deafness mutant as a model for the investigation of coding strategies for cochlear implants is discussed.