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Morlet T, Valania J, Walter C, Morini G, O'Reilly RC, Parkes W, Pritchett C. Cortical Auditory Evoked Potential Testing in Children With Auditory Neuropathy Spectrum Disorder. Am J Audiol 2023:1-12. [PMID: 38048283 DOI: 10.1044/2023_aja-23-00051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/06/2023] Open
Abstract
PURPOSE In the present report, we reviewed the role of cortical auditory evoked potentials (CAEPs) as an objective measure during the evaluation and management process in children with auditory neuropathy spectrum disorder (ANSD). METHOD We reviewed the results of CAEP recordings in 66 patients with ANSD aged between 2 months and 12 years and assessed the relationship between their characteristics (prevalence, morphology, latencies, and amplitudes) and various clinical features, including the mode of medical management. RESULTS Overall, the CAEPs were present in 85.2% of the ears tested. Factors such as prematurity, medical complexity, neuronal issues, or presence of syndromes did not have an effect on the presence or absence of CAEPs. CAEP latencies were significantly shorter in ears with cochlear nerve deficiency than in ears with a normal caliber nerve. Three different patterns of CAEP responses were observed in patients with bilateral ANSD and present cochlear nerves: (a) responses with normal morphology and presence of both P1-P2complex and N2 components, (b) responses with abnormal morphology and presence of the N2 component but undefined P1-P2complex peak, and (c) entirely absent responses. None of the patients with normal, mild, or moderate degree of hearing loss had a complete absence of CAEP responses. No significant differences were uncovered when comparing the latencies across unaided and aided children and children who later received cochlear implants. CONCLUSIONS The CAEP protocol used in our ANSD program did inform about the presence or absence of central auditory stimulation. Absent responses typically fit into an overall picture of complete auditory deprivation and all of these children were ultimately offered cochlear implants after failing to develop oral language. Present responses, on the other hand, were acknowledged as a sign of some degree of auditory stimulation but always interpreted with caution given that prognostic implications remain unclear.
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Affiliation(s)
- Thierry Morlet
- Auditory Physiology and Psychoacoustics Research Laboratory, Nemours Children Hospital, Wilmington, DE
- Department of Communication Sciences and Disorders, College of Health Sciences, University of Delaware, Newark
- Osborne College of Audiology, Salus University, Elkins Park, PA
| | | | - Cassidy Walter
- Department of Speech, Language and Hearing Sciences, The George Washington University, Washington, DC
| | - Giovanna Morini
- Department of Communication Sciences and Disorders, College of Health Sciences, University of Delaware, Newark
| | | | - William Parkes
- Department of Otolaryngology, Nemours Children Hospital, Wilmington, DE
| | - Cedric Pritchett
- Department of Otolaryngology, Nemours Children Hospital, Orlando, FL
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Fischer M, Moscovitch M, Fukuda K, Alain C. Ready for action! When the brain learns, yet memory-biased action does not follow. Neuropsychologia 2023; 189:108660. [PMID: 37604333 DOI: 10.1016/j.neuropsychologia.2023.108660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 05/23/2023] [Accepted: 08/11/2023] [Indexed: 08/23/2023]
Abstract
Does memory prepare us to act? Long-term memory can facilitate signal detection, though the degree of benefit varies and can even be absent. To dissociate between learning and behavioral expression of learning, we used high-density electroencephalography (EEG) to assess memory retrieval and response processing. At learning, participants heard everyday sounds. Half of these sound clips were paired with an above-threshold lateralized tone, such that it was possible to form incidental associations between the sound clip and the location of the tone. Importantly, attention was directed to either the sound clip (Experiment 1) or the tone (Experiment 2). Participants then completed a novel detection task that separated cued retrieval from response processing. At retrieval, we observed a striking brain-behavior dissociation. Learning was observed neurally in both experiments. Behaviorally, however, signal detection was only facilitated in Experiment 2, for which there was an accompanying explicit memory for tone presence. Further, implicit neural memory for tone location correlated with the degree of response preparation, but not response execution. Together, the findings suggest 1) that attention at learning affects memory-biased action and 2) that memory prepared action via both explicit and implicit associative memory, with the latter triggering response preparation.
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Affiliation(s)
- Manda Fischer
- Department of Psychology, University of Toronto, Toronto, Canada; Department of Psychology, Rotman Research Institute at Baycrest Hospital, Toronto, Canada.
| | - Morris Moscovitch
- Department of Psychology, University of Toronto, Toronto, Canada; Department of Psychology, Rotman Research Institute at Baycrest Hospital, Toronto, Canada.
| | - Keisuke Fukuda
- Department of Psychology, University of Toronto, Toronto, Canada.
| | - Claude Alain
- Department of Psychology, University of Toronto, Toronto, Canada; Department of Psychology, Rotman Research Institute at Baycrest Hospital, Toronto, Canada.
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Ching TYC, Zhang VW, Ibrahim R, Bardy F, Rance G, Van Dun B, Sharma M, Chisari D, Dillon H. Acoustic change complex for assessing speech discrimination in normal-hearing and hearing-impaired infants. Clin Neurophysiol 2023; 149:121-132. [PMID: 36963143 DOI: 10.1016/j.clinph.2023.02.172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Revised: 01/15/2023] [Accepted: 02/12/2023] [Indexed: 03/08/2023]
Abstract
OBJECTIVE This study examined (1) the utility of a clinical system to record acoustic change complex (ACC, an event-related potential recorded by electroencephalography) for assessing speech discrimination in infants, and (2) the relationship between ACC and functional performance in real life. METHODS Participants included 115 infants (43 normal-hearing, 72 hearing-impaired), aged 3-12 months. ACCs were recorded using [szs], [uiu], and a spectral rippled noise high-pass filtered at 2 kHz as stimuli. Assessments were conducted at age 3-6 months and at 7-12 months. Functional performance was evaluated using a parent-report questionnaire, and correlations with ACC were examined. RESULTS The rates of onset and ACC responses of normal-hearing infants were not significantly different from those of aided infants with mild or moderate hearing loss but were significantly higher than those with severe loss. On average, response rates measured at 3-6 months were not significantly different from those at 7-12 months. Higher rates of ACC responses were significantly associated with better functional performance. CONCLUSIONS ACCs demonstrated auditory capacity for discrimination in infants by 3-6 months. This capacity was positively related to real-life functional performance. SIGNIFICANCE ACCs can be used to evaluate the effectiveness of amplification and monitor development in aided hearing-impaired infants.
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Affiliation(s)
- Teresa Y C Ching
- National Acoustic Laboratories, Australia; Macquarie School of Education, Macquarie University, Australia; NextSense Institute, Australia; School of Health and Rehabilitation Sciences, University of Queensland, Australia.
| | - Vicky W Zhang
- National Acoustic Laboratories, Australia; Department of Linguistics, Macquarie University, Australia
| | - Ronny Ibrahim
- National Acoustic Laboratories, Australia; Department of Linguistics, Macquarie University, Australia
| | - Fabrice Bardy
- National Acoustic Laboratories, Australia; School of Psychology, University of Auckland, New Zealand
| | - Gary Rance
- Department of Audiology and Speech Pathology, The University of Melbourne, Australia
| | | | - Mridula Sharma
- Department of Linguistics, Macquarie University, Australia
| | - Donella Chisari
- Department of Audiology and Speech Pathology, The University of Melbourne, Australia
| | - Harvey Dillon
- National Acoustic Laboratories, Australia; Department of Linguistics, Macquarie University, Australia; Department of Hearing, University of Manchester, United Kingdom
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Forli F, Capobianco S, Berrettini S, Bruschini L, Romano S, Fogli A, Bertini V, Lazzerini F. Temperature-Sensitive Auditory Neuropathy: Report of a Novel Variant of OTOF Gene and Review of Current Literature. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:medicina59020352. [PMID: 36837553 PMCID: PMC9962730 DOI: 10.3390/medicina59020352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 02/08/2023] [Accepted: 02/10/2023] [Indexed: 02/16/2023]
Abstract
Background and objectives: Otoferlin is a multi-C2 domain protein implicated in neurotransmitter-containing vesicle release and replenishment of the cochlear inner hair cell (IHC) synapses. Mutations in the OTOF gene have been associated with two different clinical phenotypes: a prelingual severe-to-profound sensorineural hearing loss (ANSD-DFNB9); and the peculiar temperature-sensitive auditory neuropathy (TS-ANSD), characterized by a baseline mild-to-moderate hearing threshold that worsens to severe-to-profound when the body temperature rises that returns to a baseline a few hours after the temperature has fallen again. The latter clinical phenotype has been described only with a few OTOF variants with an autosomal recessive biallelic pattern of inheritance. Case report: A 7-year-old boy presented a picture compatible with TS-ANSD exacerbated by febrile states or physical exercise with mild-to-moderate hearing loss at low and medium frequencies and a decrease in speech discrimination that worsened with an unfavorable speech-to-noise ratio. Otoacoustic emissions (OAEs) were present whereas auditory brainstem responses (ABRs) evoked by a click or tone-burst were generally absent. No inner ear malformations were described from the CT scan or MRI. Next-generation sequencing (NGS) of the known deafness genes and multi-phasic bioinformatic analyses of the data detected in OTOF a c.2521G>A missense variant and the deletion of 7.4 Kb, which was confirmed by array-comparative genomic hybridization (array-CGH). The proband's parents, who were asymptomatic, were tested by Sanger sequencing and the father presented the c.2521G>A missense variant. Conclusions: The picture presented by the patient was compatible with OTOF-induced TS-ANSD. OTOF has been generally associated with an autosomal recessive biallelic pattern of inheritance; in this clinical report, two pathogenic variants never previously associated with TS-ANSD were described.
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Affiliation(s)
- Francesca Forli
- ENT, Audiology and Phoniatrics Unit, University of Pisa, 56124 Pisa, Italy
- Correspondence: ; Tel.: +39-050-997381
| | - Silvia Capobianco
- ENT, Audiology and Phoniatrics Unit, University of Pisa, 56124 Pisa, Italy
| | - Stefano Berrettini
- ENT, Audiology and Phoniatrics Unit, University of Pisa, 56124 Pisa, Italy
- Division of ENT Diseases, Karolinska Institutet, 171 77 Stockholm, Sweden
| | - Luca Bruschini
- ENT, Audiology and Phoniatrics Unit, University of Pisa, 56124 Pisa, Italy
| | - Silvia Romano
- Department of Medical and Oncological Area, Section of Medical Genetics, Azienda Ospedaliero Universitaria Pisana, 56124 Pisa, Italy
| | - Antonella Fogli
- Department of Laboratory Medicine, Section of Molecular Genetics, Azienda Ospedaliero Universitaria Pisana, 56124 Pisa, Italy
| | - Veronica Bertini
- Department of Laboratory Medicine, Section of Cytogenetics, Azienda Ospedaliero Universitaria Pisana, 56124 Pisa, Italy
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Within- and across-frequency temporal processing and speech perception in cochlear implant users. PLoS One 2022; 17:e0275772. [PMID: 36227872 PMCID: PMC9560480 DOI: 10.1371/journal.pone.0275772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Accepted: 09/23/2022] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE Cochlear implant (CI) recipient's speech perception performance is highly variable and is influenced by temporal processing abilities. Temporal processing is commonly assessed using a behavioral task that requires the participant to detect a silent gap with the pre- and post-gap stimuli of the same frequency (within-frequency gap detection) or of different frequencies (across-frequency gap detection). The purpose of the study was to evaluate behavioral and electrophysiological measures of within- and across-frequency temporal processing and their correlations with speech perception performance in CI users. DESIGN Participants included 11 post-lingually deafened adult CI users (n = 15 ears; Mean Age = 50.2 yrs) and 11 age- and gender-matched normal hearing (NH) individuals (n = 15 ears; Mean Age = 49.0 yrs). Speech perception was assessed with Consonant-Nucleus-Consonant Word Recognition (CNC), Arizona Biomedical Sentence Recognition (AzBio), and Bamford-Kowal-Bench Speech-in-Noise Test (BKB-SIN) tests. Within- and across-frequency behavioral gap detection thresholds (referred to as the GDTwithin and GDTacross) were measured using an adaptive, two-alternative, forced-choice procedure. Cortical auditory evoked potentials (CAEPs) were elicited using within- and across-frequency gap stimuli under four gap duration conditions (no gap, GDT, sub-threshold GDT, and supra-threshold GDT). Correlations among speech perception, GDTs, and CAEPs were examined. RESULTS CI users had poorer speech perception scores compared to NH listeners (p < 0.05), but the GDTs were not different between groups (p > 0.05). Compared to NH peers, CI users showed increased N1 latency in the CAEPs evoked by the across-frequency gap stimuli (p < 0.05). No group difference was observed for the CAEPs evoked by the within-frequency gap (p > 0.05). Three CI ears showing the longest GDTwithin also showed the poorest performance in speech in noise. The within-frequency CAEP increased in amplitude with the increase of gap duration; while the across-frequency CAEP displayed a similar amplitude for all gap durations. There was a significant correlation between speech scores and within-frequency CAEP measures for the supra-threshold GDT condition, with CI users with poorer speech performance having a smaller N1-P2 amplitude and longer N1 latency. No correlations were found among GDTacross, speech perception, and across-frequency CAEP measures. CONCLUSIONS Within- and across-frequency gap detection may involve different neural mechanisms. The within-frequency gap detection task can help identify CI users with poor speech performance for rehabilitation. The within-frequency CAEP is a better predictor for speech perception performance than the across-frequency CAEP.
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Savenko IV, Garbaruk ES, Boboshko MY. [The issue of auditory neuropathy: from origins to the present]. Vestn Otorinolaringol 2022; 87:60-69. [PMID: 35274894 DOI: 10.17116/otorino20228701160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The issue of auditory neuropathy spectrum disorders (ANSD) has been in a focus of specialists attention for a relatively short time, but during this time a huge amount of scientific and practical knowledge about this hearing disorder has been accumulated. ANSD is a specific auditory deficit caused by dysfunction of periphery part of the auditory system, which may affect the inner hair cells, the spiral ganglion neurons and the auditory nerve, as well as the area of synaptic contact between them, while the outer hair cells, as a rule, remain intact. As a result, a specific condition is formed, in which a patient's otoacoustic emissions and/or cochlear microphonics are present, auditory brainstem responses are abnormal or absent, electrophysiological data may not correlate with hearing level, the discrepancy between pure tone audiometry and speech discrimination is observed. ANSD prevalence, epidemiology, contemporary views on its etiology, including detailed information on hereditary forms of the disorder and its risk factors are considered in the review. The data on the basic rungs of the ANSD pathogenesis, which underlie the development of various forms of the disorder and mainly determine the rehabilitation approach, are presented. The detailed clinical and audiological characteristics of ANSD are presented; contemporary approach to ANSD diagnosis and rehabilitation, including indications for surgical treatment, are considered.
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Affiliation(s)
- I V Savenko
- Pavlov State Medical University, St. Petersburg, Russia
| | - E S Garbaruk
- Pavlov State Medical University, St. Petersburg, Russia.,St. Petersburg State Pediatric Medical University, St. Petersburg, Russia
| | - M Yu Boboshko
- Pavlov State Medical University, St. Petersburg, Russia.,Mechnikov North-Western State Medical University, St. Petersburg, Russia
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Zhu YM, Li Q, Gao X, Li YF, Liu YL, Dai P, Li XP. Familial Temperature-Sensitive Auditory Neuropathy: Distinctive Clinical Courses Caused by Variants of the OTOF Gene. Front Cell Dev Biol 2021; 9:732930. [PMID: 34692690 PMCID: PMC8529165 DOI: 10.3389/fcell.2021.732930] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Accepted: 08/31/2021] [Indexed: 11/13/2022] Open
Abstract
Objective: To investigate the clinical course and genetic etiology of familial temperature-sensitive auditory neuropathy (TSAN), which is a very rare subtype of auditory neuropathy (AN) that involves an elevation of hearing thresholds due to an increase in the core body temperature, and to evaluate the genotype-phenotype correlations in a family with TSAN. Methods: Six members of a non-consanguineous Chinese family, including four siblings complaining of communication difficulties when febrile, were enrolled in this study. The clinical and audiological profiles of the four siblings were fully evaluated during both febrile and afebrile episodes, and the genetic etiology of hearing loss (HL) was explored using next-generation sequencing (NGS) technology. Their parents, who had no complaints of fluctuating HL due to body temperature variation, were enrolled for the genetics portion only. Results: Audiological tests during the patients' febrile episodes met the classical diagnostic criteria for AN, including mild HL, poor speech discrimination, preserved cochlear microphonics (CMs), and absent auditory brainstem responses (ABRs). Importantly, unlike the pattern observed in previously reported cases of TSAN, the ABRs and electrocochleography (ECochG) signals of our patients improved to normal during afebrile periods. Genetic analysis identified a compound heterozygous variant of the OTOF gene (which encodes the otoferlin protein), including one previously reported pathogenic variant, c.5098G > C (p.Glu1700Gln), and one novel variant, c.4882C > A (p.Pro1628Thr). Neither of the identified variants affected the C2 domains related to the main function of otoferlin. Both variants faithfully cosegregated with TSAN within the pedigree, suggesting that OTOF is the causative gene of the autosomal recessive trait segregation in this family. Conclusion: The presence of CMs with absent (or markedly abnormal) ABRs is a reliable criterion for diagnosing AN. The severity of the phenotype caused by dysfunctional neurotransmitter release in TSAN may reflect variants that alter the C2 domains of otoferlin. The observations from this study enrich the current understanding of the phenotype and genotype of TSAN and may lay a foundation for further research on its pathogenesis.
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Affiliation(s)
- Yi-Ming Zhu
- Department of Otolaryngology-Head and Neck Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, China
- Department of Otolaryngology-Head and Neck Surgery, Lanzhou University Second Hospital, Lanzhou, China
| | - Qi Li
- Department of Otolaryngology-Head and Neck Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Xue Gao
- Department of Otolaryngology, PLA Rocket Force Characteristic Medical Center, Beijing, China
| | - Yan-Fei Li
- Department of Otolaryngology-Head and Neck Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - You-Li Liu
- Department of Otolaryngology-Head and Neck Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Pu Dai
- Department of Otolaryngology-Head and Neck Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, China
- Department of Otolaryngology-Head and Neck Surgery, Chinese PLA General Hospital, Beijing, China
| | - Xiang-Ping Li
- Department of Otolaryngology-Head and Neck Surgery, Nanfang Hospital, Southern Medical University, Guangzhou, China
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Kumar P, Singh NK, Sanju HK, Kaverappa GM. Feasibility of objective assessment of difference limen for intensity using acoustic change complex in children with central auditory processing disorder. Int J Pediatr Otorhinolaryngol 2020; 137:110189. [PMID: 32682166 DOI: 10.1016/j.ijporl.2020.110189] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Revised: 06/09/2020] [Accepted: 06/10/2020] [Indexed: 10/23/2022]
Abstract
INTRODUCTION Acoustic change complex (ACC) shows brain's ability to discriminate between acoustic features in an ongoing stimulus. It is this nature of ACC that has generated interest in studying the usefulness of ACC as an objective tool for evaluating difference limens for various stimulus parameters. The present study therefore aimed at investigating the utility of ACC as an objective measure of difference limen for intensity (DLI) in normal hearing children with and without (C)APD. METHODS Fifteen children with (C)APD and 15 normal hearing children in whom (C)APD was ruled out (comparison group) in the age range of 8-12 years underwent ACC for 6 intensity differences (+1, +3, +4, +5, +10 & +20 dB) and a standard stimulus using a 1000 Hz stimulus. RESULTS Behavioral DLI (DLIb) as well as DLI found using ACC (DLIo) were both significantly larger in children with (C)APD than the comparison group (p < 0.05). Further, there was a significantly strong positive correlation between DLIb and DLIo (p < 0.001]. CONCLUSION Outcome of the study provides evidence for the clinical use of ACC as an objective tool for examining DLI in children with (C)APD.
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Affiliation(s)
- Prawin Kumar
- Department of Audiology, All India Institute of Speech and Hearing, Mysore, India
| | - Niraj Kumar Singh
- Department of Audiology, All India Institute of Speech and Hearing, Mysore, India
| | - Himanshu Kumar Sanju
- Department of ENT and Audiology, Shri Jagdamba Charitable Eye Hospital, Sri Ganganagar, Rajasthan, India.
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Kumar P, Sanju HK, Hussain RO, Kaverappa Ganapathy M, Singh NK. Utility of Acoustic Change Complex as an Objective Tool to Evaluate Difference Limen for Intensity in Cochlear Hearing Loss and Auditory Neuropathy Spectrum Disorder. Am J Audiol 2020; 29:375-383. [PMID: 32628503 DOI: 10.1044/2020_aja-19-00084] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Purpose This study aimed to investigate usefulness of acoustic change complex (ACC) as an objective measure of difference limen for intensity (DLI) in auditory neuropathy spectrum disorders (ANSD) and cochlear hearing loss (CHL). Method The study used a multiple static group comparison research design. Twenty normal-hearing individuals (NH), 19 individuals with ANSD, and 23 individuals with CHL underwent DLI measurement using behavioral (psychoacoustic) techniques and ACC. For eliciting ACC, a 500-ms, 1,000-Hz pure tone was presented at 80 dB SPL. Additionally, six variants of this stimulus with intensity increments of 1, 3, 4, 5, 10, and 20 dB starting 250 ms after stimulus onset were used to elicit the ACC. Results The lowest intensity change that produced replicable and clearly identifiable ACC was referred as objective DLI. In comparison to NH and CHL, the behavioral as well as the objective DLI were significantly larger (poorer) in ANSD (p < .05). Significantly strong positive correlation existed between DLI obtained using behavioral and objective measures (p < .05). Conclusions ACC could be a useful objective tool to measure DLI in the clinical population, provided the individuals of the clinical population fulfill the prerequisite of the presence of Auditory Long Latency Responses. Supplemental Material https://doi.org/10.23641/asha.12560132.
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Affiliation(s)
- Prawin Kumar
- Department of Audiology, All India Institute of Speech and Hearing,Manasagangotri, Mysore, Karnataka, India
| | - Himanshu Kumar Sanju
- Department of Audiology, All India Institute of Speech and Hearing,Manasagangotri, Mysore, Karnataka, India
| | - Reesha Oovattil Hussain
- Department of Audiology, All India Institute of Speech and Hearing,Manasagangotri, Mysore, Karnataka, India
| | | | - Niraj Kumar Singh
- Department of Audiology, All India Institute of Speech and Hearing,Manasagangotri, Mysore, Karnataka, India
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Auditory Neuropathy Spectrum Disorders: From Diagnosis to Treatment: Literature Review and Case Reports. J Clin Med 2020; 9:jcm9041074. [PMID: 32290039 PMCID: PMC7230308 DOI: 10.3390/jcm9041074] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Revised: 03/21/2020] [Accepted: 04/01/2020] [Indexed: 12/21/2022] Open
Abstract
Auditory neuropathy spectrum disorder (ANSD) refers to a range of hearing impairments characterized by deteriorated speech perception, despite relatively preserved pure-tone detection thresholds. Affected individuals usually present with abnormal auditory brainstem responses (ABRs), but normal otoacoustic emissions (OAEs). These electrophysiological characteristics have led to the hypothesis that ANSD may be caused by various dysfunctions at the cochlear inner hair cell (IHC) and spiral ganglion neuron (SGN) levels, while the activity of outer hair cells (OHCs) is preserved, resulting in discrepancies between pure-tone and speech comprehension thresholds. The exact prevalence of ANSD remains unknown; clinical findings show a large variability among subjects with hearing impairment ranging from mild to profound hearing loss. A wide range of prenatal and postnatal etiologies have been proposed. The study of genetics and of the implicated sites of lesion correlated with clinical findings have also led to a better understanding of the molecular mechanisms underlying the various forms of ANSD, and may guide clinicians in better screening, assessment and treatment of ANSD patients. Besides OAEs and ABRs, audiological assessment includes stapedial reflex measurements, supraliminal psychoacoustic tests, electrocochleography (ECochG), auditory steady-state responses (ASSRs) and cortical auditory evoked potentials (CAEPs). Hearing aids are indicated in the treatment of ANSD with mild to moderate hearing loss, whereas cochlear implantation is the first choice of treatment in case of profound hearing loss, especially in case of IHC presynaptic disorders, or in case of poor auditory outcomes with conventional hearing aids.
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Han JH, Dimitrijevic A. Acoustic Change Responses to Amplitude Modulation in Cochlear Implant Users: Relationships to Speech Perception. Front Neurosci 2020; 14:124. [PMID: 32132897 PMCID: PMC7040081 DOI: 10.3389/fnins.2020.00124] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Accepted: 01/31/2020] [Indexed: 11/13/2022] Open
Abstract
Objectives The ability to understand speech is highly variable in people with cochlear implants (CIs) and to date, there are no objective measures that identify the root of this discrepancy. However, behavioral measures of temporal processing such as the temporal modulation transfer function (TMTF) has previously found to be related to vowel and consonant identification in CI users. The acoustic change complex (ACC) is a cortical auditory-evoked potential response that can be elicited by a “change” in an ongoing stimulus. In this study, the ACC elicited by amplitude modulation (AM) change was related to measures of speech perception as well as the amplitude detection threshold in CI users. Methods Ten CI users (mean age: 50 years old) participated in this study. All subjects participated in behavioral tests that included both speech and amplitude modulation detection to obtain a TMTF. CI users were categorized as “good” (n = 6) or “poor” (n = 4) based on their speech-in noise score (<50%). 64-channel electroencephalographic recordings were conducted while CI users passively listened to AM change sounds that were presented in a free field setting. The AM change stimulus was white noise with four different AM rates (4, 40, 100, and 300 Hz). Results Behavioral results show that AM detection thresholds in CI users were higher compared to the normal-hearing (NH) group for all AM rates. The electrophysiological data suggest that N1 responses were significantly decreased in amplitude and their latencies were increased in CI users compared to NH controls. In addition, the N1 latencies for the poor CI performers were delayed compared to the good CI performers. The N1 latency for 40 Hz AM was correlated with various speech perception measures. Conclusion Our data suggest that the ACC to AM change provides an objective index of speech perception abilities that can be used to explain some of the variation in speech perception observed among CI users.
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Affiliation(s)
- Ji-Hye Han
- Communication Sciences Research Center, Cincinnati Childs Hospital Medical Center, Cincinnati, OH, United States.,Laboratory of Brain & Cognitive Sciences for Convergence Medicine, College of Medicine, Hallym University, Chuncheon, South Korea
| | - Andrew Dimitrijevic
- Communication Sciences Research Center, Cincinnati Childs Hospital Medical Center, Cincinnati, OH, United States.,Department Otolaryngology-Head and Neck Surgery, Sunnybrook Health Sciences Centre, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
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Abstract
OBJECTIVES The objectives of this study were to measure the effects of level and vowel contrast on the latencies and amplitudes of acoustic change complex (ACC) in the mature auditory system. This was done to establish how the ACC in healthy young adults is affected by these stimulus parameters that could then be used to inform translation of the ACC into a clinical measure for the pediatric population. Another aim was to demonstrate that a normalized amplitude metric, calculated by dividing the ACC amplitude in the vowel contrast condition by the ACC amplitude obtained in a control condition (no vowel change) would demonstrate good sensitivity with respect to perceptual measures of vowel-contrast detection. The premises underlying this research were that: (1) ACC latencies and amplitudes would vary with level, in keeping with principles of an increase in neural synchrony and activity that takes place as a function of increasing stimulus level; (2) ACC latencies and amplitudes would vary with vowel contrast, because cortical auditory evoked potentials are known to be sensitive to the spectro-temporal characteristics of speech. DESIGN Nineteen adults, 14 of them female, with a mean age of 24.2 years (range 20 to 38 years) participated in this study. All had normal-hearing thresholds. Cortical auditory evoked potentials were obtained from all participants in response to synthesized vowel tokens (/a/, /i/, /o/, /u/), presented in a quasi-steady state fashion at a rate of 2/sec in an oddball stimulus paradigm, with a 25% probability of the deviant stimulus. The ACC was obtained in response to the deviant stimulus. All combinations of vowel tokens were tested at 2 stimulus levels: 40 and 70 dBA. In addition, listeners were tested for their ability to detect the vowel contrasts using behavioral methods. RESULTS ACC amplitude varied systematically with level, and test condition (control versus contrast) and vowel token, but ACC latency did not. ACC amplitudes were significantly larger when tested at 70 dBA compared with 40 dBA and for contrast trials compared with control trials at both levels. Amplitude ratios (normalized amplitudes) were largest for contrast pairs in which /a/ was the standard token. The amplitude ratio metric at the individual level demonstrated up to 97% sensitivity with respect to perceptual measures of discrimination. CONCLUSIONS The present study establishes the effects of stimulus level and vowel type on the latency and amplitude of the ACC in the young adult auditory system and supports the amplitude ratio as a sensitive metric for cortical acoustic salience of vowel spectral features. Next steps are to evaluate these methods in infants and children with hearing loss with the long-term goal of its translation into a clinical method for estimating speech feature discrimination.
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Presacco A, Middlebrooks JC. Tone-Evoked Acoustic Change Complex (ACC) Recorded in a Sedated Animal Model. J Assoc Res Otolaryngol 2018; 19:451-466. [PMID: 29749573 DOI: 10.1007/s10162-018-0673-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2017] [Accepted: 04/24/2018] [Indexed: 11/30/2022] Open
Abstract
The acoustic change complex (ACC) is a scalp-recorded cortical evoked potential complex generated in response to changes (e.g., frequency, amplitude) in an auditory stimulus. The ACC has been well studied in humans, but to our knowledge, no animal model has been evaluated. In particular, it was not known whether the ACC could be recorded under the conditions of sedation that likely would be necessary for recordings from animals. For that reason, we tested the feasibility of recording ACC from sedated cats in response to changes of frequency and amplitude of pure-tone stimuli. Cats were sedated with ketamine and acepromazine, and subdermal needle electrodes were used to record electroencephalographic (EEG) activity. Tones were presented from a small loudspeaker located near the right ear. Continuous tones alternated at 500-ms intervals between two frequencies or two levels. Neurometric functions were created by recording neural response amplitudes while systematically varying the magnitude of steps in frequency centered in octave frequency around 2, 4, 8, and 16 kHz, all at 75 dB SPL, or in decibel level around 75 dB SPL tested at 4 and 8 kHz. The ACC could be recorded readily under this ketamine/azepromazine sedation. In contrast, ACC could not be recorded reliably under any level of isoflurane anesthesia that was tested. The minimum frequency (expressed as Weber fractions (df/f)) or level steps (expressed in dB) needed to elicit ACC fell in the range of previous thresholds reported in animal psychophysical tests of discrimination. The success in recording ACC in sedated animals suggests that the ACC will be a useful tool for evaluation of other aspects of auditory acuity in normal hearing and, presumably, in electrical cochlear stimulation, especially for novel stimulation modes that are not yet feasible in humans.
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Affiliation(s)
- Alessandro Presacco
- Department of Otolaryngology, University of California at Irvine, Irvine, CA, 92697-5310, USA.
- Center for Hearing Research, University of California at Irvine, Irvine, CA, USA.
| | - John C Middlebrooks
- Department of Otolaryngology, University of California at Irvine, Irvine, CA, 92697-5310, USA
- Center for Hearing Research, University of California at Irvine, Irvine, CA, USA
- Department of Neurobiology and Behavior, University of California at Irvine, Irvine, CA, USA
- Department of Cognitive Sciences, University of California at Irvine, Irvine, CA, USA
- Department of Biomedical Engineering, University of California at Irvine, Irvine, CA, USA
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Kalaiah MK. Acoustic change complex for frequency changes. HEARING, BALANCE AND COMMUNICATION 2018. [DOI: 10.1080/21695717.2017.1421813] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Mohan Kumar Kalaiah
- Department of Audiology and Speech Language Pathology, Kasturba Medical College, Manipal Academy of Higher Education, Mangalore, Karnataka, India
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15
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Kalaiah MK, Shastri U. Cortical Auditory Event Related Potentials (P300) for Frequency Changing Dynamic Tones. J Audiol Otol 2016; 20:22-30. [PMID: 27144230 PMCID: PMC4853895 DOI: 10.7874/jao.2016.20.1.22] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2015] [Revised: 12/11/2015] [Accepted: 01/29/2016] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND AND OBJECTIVES P300 has been studied with a variety of stimuli. However, the nature of P300 has not been investigated for deviant stimuli which change its characteristics from standard stimuli after a period of time from onset. SUBJECTS AND METHODS Nine young adults with normal hearing participated in the study. The P300 was elicited using an oddball paradigm, the probability of standard and deviant stimuli was 80% and 20% respectively. Six stimuli were used to elicit P300, it included two pure-tones (1,000 Hz and 2,000 Hz) and four tone-complexes (tones with frequency changes). Among these stimuli, 1,000 Hz tone served as standard while others served as deviant stimuli. The P300 was recorded in five separate blocks, with one of the deviant stimuli as target in each block. Electroencephalographic was recorded from electrode sites Fz, Cz, C3, C4, and Pz. Latency and amplitude of components of the cortical auditory evoked potentials were measured at Cz. RESULTS Waveforms obtained in the present study shows that, all the deviant stimuli elicited obligatory P1-N1-P2 for stimulus onset. 2,000 Hz deviant tone elicited P300 at a latency of 300 ms. While, tone-complexes elicited acoustic change complex (ACC) for frequency changes and finally elicited P300 at a latency of 600 ms. In addition, the results showed shorter latency and larger amplitude ACC and P300 for rising tone-complexes compared to falling tone-complexes. CONCLUSIONS Tone-complexes elicited distinct waveforms compared to 2,000 Hz deviant tone. Rising tone-complexes which had an increase in frequency elicited shorter latency and larger amplitude responses, which could be attributed to perceptual bias for frequency changes.
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Affiliation(s)
- Mohan Kumar Kalaiah
- Department of Audiology and Speech Language Pathology, Kasturba Medical College (Manipal University), Mangalore, Karnataka, India
| | - Usha Shastri
- NITTE Institute of Speech and Hearing, Mangalore, Karnataka, India
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Acoustically evoked auditory change complex in children with auditory neuropathy spectrum disorder: a potential objective tool for identifying cochlear implant candidates. Ear Hear 2016; 36:289-301. [PMID: 25422994 DOI: 10.1097/aud.0000000000000119] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES The overall aim of the study was to evaluate the feasibility of using electrophysiological measures of the auditory change complex (ACC) to identify candidates for cochlear implantation in children with auditory neuropathy spectrum disorder (ANSD). To achieve this overall aim, this study (1) assessed the feasibility of measuring the ACC evoked by temporal gaps in a group of children with ANSD across a wide age range and (2) investigated the association between gap detection thresholds (GDTs) measured by the ACC recordings and open-set speech-perception performance in these subjects. DESIGN Nineteen children with bilateral ANSD ranging in age between 1.9 and 14.9 years (mean: 7.8 years) participated in this study. Electrophysiological recordings of the auditory event-related potential (ERP), including the onset ERP response and the ACC, were completed in all subjects and open-set speech perception was evaluated for a subgroup of 16 subjects. For the ERP recordings, the stimulus was a Gaussian noise presented through ER-3A insert earphones to the test ear. Two stimulation conditions were used. In the "control condition," the stimulus was an 800-msec Gaussian noise. In the "gapped condition," the stimuli were two noise segments, each being 400 msec in duration, separated by one of five gaps (i.e., 5, 10, 20, 50, or 100 msec). The interstimulation interval was 1200 msec. The aided open-set speech perception ability was assessed using the Phonetically Balanced Kindergarten (PBK) word lists presented at 60 dB SPL using recorded testing material in a sound booth. For speech perception tests, subjects wore their hearing aids at the settings recommended by their clinical audiologists. For a subgroup of five subjects, psychophysical GDTs for the Gaussian noise were also assessed using a three-interval, three-alternative forced-choice procedure. RESULTS Responses evoked by the onset of the Gaussian noise (i.e., onset responses) were recorded in all stimulation conditions from all subjects tested in this study. The presence/absence, peak latency and amplitude, and response width of the onset response did not correlate with aided PBK word scores. The objective GDTs measured with the ACC recordings from 17 subjects ranged from 10 to 100 msec. The ACC was not recorded from two subjects for any gap durations tested in this study. There was a robust negative correlation between objective GDTs and aided PBK word scores. In general, subjects with prolonged objective GDTs showed low-aided PBK word scores. GDTs measured using electrophysiological recordings of the ACC correlated well with those measured using psychophysical procedures in four of five subjects who were evaluated using both procedures. CONCLUSIONS The clinical application of the onset response in predicting open-set speech-perception ability is relatively limited in children with ANSD. The ACC recordings can be used to objectively evaluate temporal resolution abilities in children with ANSD having no severe comorbidities, and who are older than 1.9 years. The ACC can potentially be used as an objective tool to identify poor performers among children with ANSD using properly fit amplification, and who are thus, cochlear implant candidates.
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17
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Kim JR. Acoustic Change Complex: Clinical Implications. J Audiol Otol 2015; 19:120-4. [PMID: 26771009 PMCID: PMC4704548 DOI: 10.7874/jao.2015.19.3.120] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2015] [Revised: 11/16/2015] [Accepted: 11/18/2015] [Indexed: 11/22/2022] Open
Abstract
The acoustic change complex (ACC) is a cortical auditory evoked potential elicited in response to a change in an ongoing sound. The characteristics and potential clinical implications of the ACC are reviewed in this article. The P1-N1-P2 recorded from the auditory cortex following presentation of an acoustic stimulus is believed to reflect the neural encoding of a sound signal, but this provides no information regarding sound discrimination. However, the neural processing underlying behavioral discrimination capacity can be measured by modifying the traditional methodology for recording the P1-N1-P2. When obtained in response to an acoustic change within an ongoing sound, the resulting waveform is referred to as the ACC. When elicited, the ACC indicates that the brain has detected changes within a sound and the patient has the neural capacity to discriminate the sounds. In fact, results of several studies have shown that the ACC amplitude increases with increasing magnitude of acoustic changes in intensity, spectrum, and gap duration. In addition, the ACC can be reliably recorded with good test-retest reliability not only from listeners with normal hearing but also from individuals with hearing loss, hearing aids, and cochlear implants. The ACC can be obtained even in the absence of attention, and requires relatively few stimulus presentations to record a response with a good signal-to-noise ratio. Most importantly, the ACC shows reasonable agreement with behavioral measures. Therefore, these findings suggest that the ACC might represent a promising tool for the objective clinical evaluation of auditory discrimination and/or speech perception capacity.
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Affiliation(s)
- Jae-Ryong Kim
- Department of Otolaryngology-Head and Neck Surgery, Busan Paik Hospital, Inje University College of Medicine, Busan, Korea
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18
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Rance G, Starr A. Pathophysiological mechanisms and functional hearing consequences of auditory neuropathy. Brain 2015; 138:3141-58. [PMID: 26463676 DOI: 10.1093/brain/awv270] [Citation(s) in RCA: 104] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2015] [Accepted: 08/05/2015] [Indexed: 01/19/2023] Open
Abstract
The effects of inner ear abnormality on audibility have been explored since the early 20th century when sound detection measures were first used to define and quantify 'hearing loss'. The development in the 1970s of objective measures of cochlear hair cell function (cochlear microphonics, otoacoustic emissions, summating potentials) and auditory nerve/brainstem activity (auditory brainstem responses) have made it possible to distinguish both synaptic and auditory nerve disorders from sensory receptor loss. This distinction is critically important when considering aetiology and management. In this review we address the clinical and pathophysiological features of auditory neuropathy that distinguish site(s) of dysfunction. We describe the diagnostic criteria for: (i) presynaptic disorders affecting inner hair cells and ribbon synapses; (ii) postsynaptic disorders affecting unmyelinated auditory nerve dendrites; (iii) postsynaptic disorders affecting auditory ganglion cells and their myelinated axons and dendrites; and (iv) central neural pathway disorders affecting the auditory brainstem. We review data and principles to identify treatment options for affected patients and explore their benefits as a function of site of lesion.
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Affiliation(s)
- Gary Rance
- 1 Department of Audiology and Speech Pathology, The University of Melbourne, 550 Swanston Street, Parkville 3010 Australia
| | - Arnold Starr
- 2 Department of Neurology, The University of California (Irvine), 200 S. Manchester Ave., Suite 206, Orange, CA 92868-4280, USA
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Objective measures of electrode discrimination with electrically evoked auditory change complex and speech-perception abilities in children with auditory neuropathy spectrum disorder. Ear Hear 2015; 35:e63-74. [PMID: 24231629 DOI: 10.1097/01.aud.0000436605.92129.1b] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES This study aimed to (1) determine the sensitivity of the electrically evoked auditory change complex (eACC) to changes in stimulating electrode position; and (2) investigate the association between results of eACC measures and behavioral electrode discrimination and their association with speech-perception performance in pediatric cochlear implant (CI) users who have auditory neuropathy spectrum disorder (ANSD). DESIGN Fifteen children with ANSD ranging in age between 5.4 and 18.6 years participated in this study. All subjects used Cochlear Nucleus devices. For each subject, open-set speech-perception ability was assessed using the Phonetically Balanced Kindergarten word lists presented at 60 dB SPL, using monitored live voice in a sound booth. Behavioral and objective measures of electrode discrimination were assessed in a nonclinical test environment. The stimuli used to elicit these measures were 800 msec biphasic pulse trains delivered by a direct interface to the CI. Data were collected from two basic stimulation conditions. In the standard condition, the entire pulse train was delivered to a mid-array electrode (electrode 11 or 12) at the maximum comfortable level (C level). In the change condition, the stimulus was split into two 400 msec pulse train segments presented sequentially on two different electrodes. The stimulation level of the second 400 msec pulse train was loudness balanced to the C level of the mid-array electrode used in the standard condition. The separation between the pair of stimulating electrodes was systematically varied. For behavioral electrode-discrimination measures, each subject was required to determine whether he or she heard one or two sounds for stimuli presented in different stimulation conditions. For the eACC measures, two replicates of 100 artifact-free sweeps were recorded for each stimulation condition. RESULTS The eACC in response to changes in stimulating electrode position was recorded from all subjects with ANSD using direct electrical stimulation. Electrode-discrimination thresholds determined with the eACC and behavioral measures were consistent. Children with ANSD using CIs who showed poorer speech performance also required larger separations between the stimulating electrode pair to reliably elicit the eACC than subjects with better speech-perception performance. There was a robust correlation between electrode-discrimination capacities and speech-perception performances in subjects tested in this study. The effect of electrode separation on eACC amplitudes was not monotonic. CONCLUSIONS These results demonstrate the feasibility of using eACC to evaluate electrode-discrimination capacities in children with ANSD. These results suggest that the eACC elicited by changes in stimulating electrode position holds great promise as an objective tool for evaluating spectral-pattern detection in such subjects, which may be predictive of their potential speech-perception performance.
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He S, Grose JH, Teagle HFB, Woodard J, Park LR, Hatch DR, Buchman CA. Gap detection measured with electrically evoked auditory event-related potentials and speech-perception abilities in children with auditory neuropathy spectrum disorder. Ear Hear 2013; 34:733-44. [PMID: 23722354 PMCID: PMC3796190 DOI: 10.1097/aud.0b013e3182944bb5] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES This study aimed (1) to investigate the feasibility of recording the electrically evoked auditory event-related potential (eERP), including the onset P1-N1-P2 complex and the electrically evoked auditory change complex (EACC) in response to temporal gaps, in children with auditory neuropathy spectrum disorder (ANSD); and (2) to evaluate the relationship between these measures and speech-perception abilities in these subjects. DESIGN Fifteen ANSD children who are Cochlear Nucleus device users participated in this study. For each subject, the speech-processor microphone was bypassed and the eERPs were elicited by direct stimulation of one mid-array electrode (electrode 12). The stimulus was a train of biphasic current pulses 800 msec in duration. Two basic stimulation conditions were used to elicit the eERP. In the no-gap condition, the entire pulse train was delivered uninterrupted to electrode 12, and the onset P1-N1-P2 complex was measured relative to the stimulus onset. In the gapped condition, the stimulus consisted of two pulse train bursts, each being 400 msec in duration, presented sequentially on the same electrode and separated by one of five gaps (i.e., 5, 10, 20, 50, and 100 msec). Open-set speech-perception ability of these subjects with ANSD was assessed using the phonetically balanced kindergarten (PBK) word lists presented at 60 dB SPL, using monitored live voice in a sound booth. RESULTS The eERPs were recorded from all subjects with ANSD who participated in this study. There were no significant differences in test-retest reliability, root mean square amplitude or P1 latency for the onset P1-N1-P2 complex between subjects with good (>70% correct on PBK words) and poorer speech-perception performance. In general, the EACC showed less mature morphological characteristics than the onset P1-N1-P2 response recorded from the same subject. There was a robust correlation between the PBK word scores and the EACC thresholds for gap detection. Subjects with poorer speech-perception performance showed larger EACC thresholds in this study. CONCLUSIONS These results demonstrate the feasibility of recording eERPs from implanted children with ANSD, using direct electrical stimulation. Temporal-processing deficits, as demonstrated by large EACC thresholds for gap detection, might account in part for the poor speech-perception performances observed in a subgroup of implanted subjects with ANSD. This finding suggests that the EACC elicited by changes in temporal continuity (i.e., gap) holds promise as a predictor of speech-perception ability among implanted children with ANSD.
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Affiliation(s)
- Shuman He
- Department Otolaryngology-Head and Neck Surgery, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
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21
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Wynne DP, Zeng FG, Bhatt S, Michalewski HJ, Dimitrijevic A, Starr A. Loudness adaptation accompanying ribbon synapse and auditory nerve disorders. ACTA ACUST UNITED AC 2013; 136:1626-38. [PMID: 23503620 DOI: 10.1093/brain/awt056] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Abnormal auditory adaptation is a standard clinical tool for diagnosing auditory nerve disorders due to acoustic neuromas. In the present study we investigated auditory adaptation in auditory neuropathy owing to disordered function of inner hair cell ribbon synapses (temperature-sensitive auditory neuropathy) or auditory nerve fibres. Subjects were tested when afebrile for (i) psychophysical loudness adaptation to comfortably-loud sustained tones; and (ii) physiological adaptation of auditory brainstem responses to clicks as a function of their position in brief 20-click stimulus trains (#1, 2, 3 … 20). Results were compared with normal hearing listeners and other forms of hearing impairment. Subjects with ribbon synapse disorder had abnormally increased magnitude of loudness adaptation to both low (250 Hz) and high (8000 Hz) frequency tones. Subjects with auditory nerve disorders had normal loudness adaptation to low frequency tones; all but one had abnormal adaptation to high frequency tones. Adaptation was both more rapid and of greater magnitude in ribbon synapse than in auditory nerve disorders. Auditory brainstem response measures of adaptation in ribbon synapse disorder showed Wave V to the first click in the train to be abnormal both in latency and amplitude, and these abnormalities increased in magnitude or Wave V was absent to subsequent clicks. In contrast, auditory brainstem responses in four of the five subjects with neural disorders were absent to every click in the train. The fifth subject had normal latency and abnormally reduced amplitude of Wave V to the first click and abnormal or absent responses to subsequent clicks. Thus, dysfunction of both synaptic transmission and auditory neural function can be associated with abnormal loudness adaptation and the magnitude of the adaptation is significantly greater with ribbon synapse than neural disorders.
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Affiliation(s)
- Dwight P Wynne
- Department of Biomedical Engineering, University of California, Irvine, CA 92697, USA.
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He S, Grose JH, Buchman CA. Auditory discrimination: the relationship between psychophysical and electrophysiological measures. Int J Audiol 2013; 51:771-82. [PMID: 22998415 DOI: 10.3109/14992027.2012.699198] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVES This study aimed to (1) investigate the relationship between the acoustic change complex (ACC) and perceptual measures of frequency and intensity discrimination, and gap detection; and (2) examine the effects of acoustic change on the amplitudes and latencies of the ACC. DESIGN Psychophysical thresholds for frequency and intensity discrimination and gap detection, as well as ACCs elicited by stimuli containing increments in frequency, or intensity or gaps, were recorded from the same group of subjects. The magnitude of the acoustic change was systematically varied for the ACC recording. STUDY SAMPLE Twenty-six adults with normal hearing, ranging in age between 19 and 39 years. RESULTS Electrophysiological and psychophysical measures for frequency and intensity discrimination were significantly correlated. Electrophysiological thresholds were comparable to psychophysical thresholds for intensity discrimination but were higher than psychophysical thresholds for gap detection and frequency discrimination. Increasing the magnitude of acoustic change increased the ACC amplitude but did not show consistent effects across acoustic dimensions for ACC latency. CONCLUSIONS The ACC can be used as an objective index of auditory discrimination in frequency and intensity. The ACC amplitude is a better indicator for auditory processing than the ACC latency.
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Affiliation(s)
- Shuman He
- Department of Otolaryngology-Head and Neck Surgery, The University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-7070, USA.
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Cardon G, Campbell J, Sharma A. Plasticity in the developing auditory cortex: evidence from children with sensorineural hearing loss and auditory neuropathy spectrum disorder. J Am Acad Audiol 2012; 23:396-411; quiz 495. [PMID: 22668761 DOI: 10.3766/jaaa.23.6.3] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The developing auditory cortex is highly plastic. As such, the cortex is both primed to mature normally and at risk for reorganizing abnormally, depending upon numerous factors that determine central maturation. From a clinical perspective, at least two major components of development can be manipulated: (1) input to the cortex and (2) the timing of cortical input. Children with sensorineural hearing loss (SNHL) and auditory neuropathy spectrum disorder (ANSD) have provided a model of early deprivation of sensory input to the cortex and demonstrated the resulting plasticity and development that can occur upon introduction of stimulation. In this article, we review several fundamental principles of cortical development and plasticity and discuss the clinical applications in children with SNHL and ANSD who receive intervention with hearing aids and/or cochlear implants.
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Affiliation(s)
- Garrett Cardon
- Speech, Language and Hearing Sciences Department, University of Colorado at Boulder, Boulder, CO 80309, USA
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Giraudet F, Avan P. Auditory neuropathies: understanding their pathogenesis to illuminate intervention strategies. Curr Opin Neurol 2012; 25:50-6. [PMID: 22185903 DOI: 10.1097/wco.0b013e32834f0351] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
PURPOSE OF REVIEW For lack of therapy targeting sensorineural hearing loss, hearing-impaired patients must be fitted with sound-amplifying hearing aids or cochlear implants, successfully in a majority of cases. Yet failures are often found among auditory neuropathies. RECENT FINDINGS Auditory neuropathies are a class of conditions characterized by disrupted spike synchrony in auditory pathways despite reasonably preserved hearing sensitivity: amplification by hearing aids is inadequate and electrical stimulation of the auditory nerve may not improve discharge synchrony. SUMMARY Among the already partially understood pathogenetic frameworks, this article reviews physiological reasons why some rehabilitation procedures can restore neural synchrony, whereas others either fail or might even increase the damage, and what tests could help predict the outcome of intervention.
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Affiliation(s)
- Fabrice Giraudet
- Laboratory of Sensory Biophysics, University of Auvergne, Clermont-Ferrand, France
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