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Nemati S, Arjmandi M, Busby N, Bonilha L, Fridriksson J. The impact of age-related hearing loss on cognitive decline: The mediating role of brain age gap. Neuroscience 2024; 551:185-195. [PMID: 38838977 DOI: 10.1016/j.neuroscience.2024.05.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Revised: 05/01/2024] [Accepted: 05/03/2024] [Indexed: 06/07/2024]
Abstract
In recent years, the relationship between age-related hearing loss, cognitive decline, and the risk of dementia has garnered significant attention. The significant variability in brain health and aging among individuals of the same chronological age suggests that a measure assessing how one's brain ages may better explain hearing-cognition links. The main aim of this study was to investigate the mediating role of Brain Age Gap (BAG) in the association between hearing impairment and cognitive function. This research included 185 participants aged 20-79 years. BAG was estimated based on the difference between participant's brain age (estimated based on their structural T1-weighted MRI scans) and chronological age. Cognitive performance was assessed using the Montreal Cognitive Assessment (MoCA) test while hearing ability was measured using pure-tone thresholds (PTT) and words-in-noise (WIN) perception. Mediation analyses were used to examine the mediating role of BAG in the relationship between age-related hearing loss as well as difficulties in WIN perception and cognition. Participants with poorer hearing sensitivity and WIN perception showed lower MoCA scores, but this was an indirect effect. Participants with poorer performance on PTT and WIN tests had larger BAG (accelerated brain aging), and this was associated with poorer performance on the MoCA test. Mediation analyses showed that BAG partially mediated the relationship between age-related hearing loss and cognitive decline. This study enhances our understanding of the interplay among hearing loss, cognition, and BAG, emphasizing the potential value of incorporating brain age assessments in clinical evaluations to gain insights beyond chronological age, thus advancing strategies for preserving cognitive health in aging populations.
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Affiliation(s)
- Samaneh Nemati
- Department of Communication Sciences and Disorders, University of South Carolina, Columbia, SC, USA.
| | - Meisam Arjmandi
- Department of Communication Sciences and Disorders, University of South Carolina, Columbia, SC, USA
| | - Natalie Busby
- Department of Communication Sciences and Disorders, University of South Carolina, Columbia, SC, USA
| | - Leonardo Bonilha
- Department of Neurology, University of South Carolina, Columbia, SC, USA
| | - Julius Fridriksson
- Department of Communication Sciences and Disorders, University of South Carolina, Columbia, SC, USA
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Jeschke L, Mathias B, von Kriegstein K. Inhibitory TMS over Visual Area V5/MT Disrupts Visual Speech Recognition. J Neurosci 2023; 43:7690-7699. [PMID: 37848284 PMCID: PMC10634547 DOI: 10.1523/jneurosci.0975-23.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Revised: 07/26/2023] [Accepted: 09/04/2023] [Indexed: 10/19/2023] Open
Abstract
During face-to-face communication, the perception and recognition of facial movements can facilitate individuals' understanding of what is said. Facial movements are a form of complex biological motion. Separate neural pathways are thought to processing (1) simple, nonbiological motion with an obligatory waypoint in the motion-sensitive visual middle temporal area (V5/MT); and (2) complex biological motion. Here, we present findings that challenge this dichotomy. Neuronavigated offline transcranial magnetic stimulation (TMS) over V5/MT on 24 participants (17 females and 7 males) led to increased response times in the recognition of simple, nonbiological motion as well as visual speech recognition compared with TMS over the vertex, an active control region. TMS of area V5/MT also reduced practice effects on response times, that are typically observed in both visual speech and motion recognition tasks over time. Our findings provide the first indication that area V5/MT causally influences the recognition of visual speech.SIGNIFICANCE STATEMENT In everyday face-to-face communication, speech comprehension is often facilitated by viewing a speaker's facial movements. Several brain areas contribute to the recognition of visual speech. One area of interest is the motion-sensitive visual medial temporal area (V5/MT), which has been associated with the perception of simple, nonbiological motion such as moving dots, as well as more complex, biological motion such as visual speech. Here, we demonstrate using noninvasive brain stimulation that area V5/MT is causally relevant in recognizing visual speech. This finding provides new insights into the neural mechanisms that support the perception of human communication signals, which will help guide future research in typically developed individuals and populations with communication difficulties.
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Affiliation(s)
- Lisa Jeschke
- Chair of Cognitive and Clinical Neuroscience, Faculty of Psychology, Technische Universität Dresden, 01069 Dresden, Germany
| | - Brian Mathias
- School of Psychology, University of Aberdeen, Aberdeen AB243FX, United Kingdom
| | - Katharina von Kriegstein
- Chair of Cognitive and Clinical Neuroscience, Faculty of Psychology, Technische Universität Dresden, 01069 Dresden, Germany
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Fuksa J, Profant O, Tintěra J, Svobodová V, Tóthová D, Škoch A, Syka J. Functional changes in the auditory cortex and associated regions caused by different acoustic stimuli in patients with presbycusis and tinnitus. Front Neurosci 2022; 16:921873. [PMID: 36340777 PMCID: PMC9626994 DOI: 10.3389/fnins.2022.921873] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Accepted: 08/31/2022] [Indexed: 09/30/2023] Open
Abstract
Presbycusis and tinnitus are the two most common hearing related pathologies. Although both of these conditions presumably originate in the inner ear, there are several reports concerning their central components. Interestingly, the onset of presbycusis coincides with the highest occurrence of tinnitus. The aim of this study was to identify age, hearing loss, and tinnitus related functional changes, within the auditory system and its associated structures. Seventy-eight participants were selected for the study based on their age, hearing, and tinnitus, and they were divided into six groups: young controls (Y-NH-NT), subjects with mild presbycusis (O-NH-NT) or expressed presbycusis (O-HL-NT), young subjects with tinnitus (Y-NH-T), subjects with mild presbycusis and tinnitus (O-NH-T), and subjects with expressed presbycusis and tinnitus (O-HL-T). An MRI functional study was performed with a 3T MRI system, using an event related design (different types of acoustic and visual stimulations and their combinations). The amount of activation of the auditory cortices (ACs) was dependent on the complexity of the stimuli; higher complexity resulted in a larger area of the activated cortex. Auditory stimulation produced a slightly greater activation in the elderly, with a negative effect of hearing loss (lower activation). The congruent audiovisual stimulation led to an increased activity within the default mode network, whereas incongruent stimulation led to increased activation of the visual cortex. The presence of tinnitus increased activation of the AC, specifically in the aged population, with a slight prevalence in the left AC. The occurrence of tinnitus was accompanied by increased activity within the insula and hippocampus bilaterally. Overall, we can conclude that expressed presbycusis leads to a lower activation of the AC, compared to the elderly with normal hearing; aging itself leads to increased activity in the right AC. The complexity of acoustic stimuli plays a major role in the activation of the AC, its support by visual stimulation leads to minimal changes within the AC. Tinnitus causes changes in the activity of the limbic system, as well as in the auditory AC, where it is bound to the left hemisphere.
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Affiliation(s)
- Jakub Fuksa
- Department of Otorhinolaryngology, 3rd Faculty of Medicine, Faculty Hospital Královské Vinohrady, Charles University, Prague, Czechia
- Department of Auditory Neuroscience, Institute of Experimental Medicine, The Czech Academy of Sciences, Prague, Czechia
| | - Oliver Profant
- Department of Otorhinolaryngology, 3rd Faculty of Medicine, Faculty Hospital Královské Vinohrady, Charles University, Prague, Czechia
- Department of Auditory Neuroscience, Institute of Experimental Medicine, The Czech Academy of Sciences, Prague, Czechia
| | - Jaroslav Tintěra
- MR Unit, Institute for Clinical and Experimental Medicine, Prague, Czechia
| | - Veronika Svobodová
- Department of Auditory Neuroscience, Institute of Experimental Medicine, The Czech Academy of Sciences, Prague, Czechia
- Department of Otorhinolaryngology, Head and Neck Surgery, 1st Faculty of Medicine, Charles University in Prague and University Hospital Motol, Prague, Czechia
| | - Diana Tóthová
- Department of Auditory Neuroscience, Institute of Experimental Medicine, The Czech Academy of Sciences, Prague, Czechia
- Department of Otorhinolaryngology, Head and Neck Surgery, 1st Faculty of Medicine, Charles University in Prague and University Hospital Motol, Prague, Czechia
| | - Antonin Škoch
- MR Unit, Institute for Clinical and Experimental Medicine, Prague, Czechia
| | - Josef Syka
- Department of Auditory Neuroscience, Institute of Experimental Medicine, The Czech Academy of Sciences, Prague, Czechia
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Butera IM, Larson ED, DeFreese AJ, Lee AKC, Gifford RH, Wallace MT. Functional localization of audiovisual speech using near infrared spectroscopy. Brain Topogr 2022; 35:416-430. [PMID: 35821542 PMCID: PMC9334437 DOI: 10.1007/s10548-022-00904-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Accepted: 05/19/2022] [Indexed: 11/21/2022]
Abstract
Visual cues are especially vital for hearing impaired individuals such as cochlear implant (CI) users to understand speech in noise. Functional Near Infrared Spectroscopy (fNIRS) is a light-based imaging technology that is ideally suited for measuring the brain activity of CI users due to its compatibility with both the ferromagnetic and electrical components of these implants. In a preliminary step toward better elucidating the behavioral and neural correlates of audiovisual (AV) speech integration in CI users, we designed a speech-in-noise task and measured the extent to which 24 normal hearing individuals could integrate the audio of spoken monosyllabic words with the corresponding visual signals of a female speaker. In our behavioral task, we found that audiovisual pairings provided average improvements of 103% and 197% over auditory-alone listening conditions in -6 and -9 dB signal-to-noise ratios consisting of multi-talker background noise. In an fNIRS task using similar stimuli, we measured activity during auditory-only listening, visual-only lipreading, and AV listening conditions. We identified cortical activity in all three conditions over regions of middle and superior temporal cortex typically associated with speech processing and audiovisual integration. In addition, three channels active during the lipreading condition showed uncorrected correlations associated with behavioral measures of audiovisual gain as well as with the McGurk effect. Further work focusing primarily on the regions of interest identified in this study could test how AV speech integration may differ for CI users who rely on this mechanism for daily communication.
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Affiliation(s)
- Iliza M. Butera
- grid.152326.10000 0001 2264 7217Vanderbilt Brain Institute, Vanderbilt University, Nashville, TN USA
| | - Eric D. Larson
- grid.34477.330000000122986657Institute for Learning & Brain Sciences, University of Washington, Seattle Washington, USA
| | - Andrea J. DeFreese
- grid.152326.10000 0001 2264 7217Department of Hearing and Speech Sciences, Vanderbilt University, Nashville, TN USA
| | - Adrian KC Lee
- grid.34477.330000000122986657Institute for Learning & Brain Sciences, University of Washington, Seattle Washington, USA ,grid.34477.330000000122986657Department of Speech and Hearing Sciences, University of Washington, Seattle, Washington USA
| | - René H. Gifford
- grid.152326.10000 0001 2264 7217Department of Hearing and Speech Sciences, Vanderbilt University, Nashville, TN USA
| | - Mark T. Wallace
- grid.152326.10000 0001 2264 7217Vanderbilt Brain Institute, Vanderbilt University, Nashville, TN USA ,grid.152326.10000 0001 2264 7217Department of Hearing and Speech Sciences, Vanderbilt University, Nashville, TN USA ,grid.412807.80000 0004 1936 9916Vanderbilt Kennedy Center, Vanderbilt University Medical Center, Nashville, TN USA
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Kitada R, Sadato N. Multisensory integration and its plasticity - How do innate and postnatal factors contribute to forming individual differences? Cortex 2021; 145:A1-A4. [PMID: 34844700 DOI: 10.1016/j.cortex.2021.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Ryo Kitada
- School of Social Sciences, Nanyang Technological University, Singapore; Graduate School of Intercultural Studies, Kobe University, Japan.
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Delirium and Clusters of Older Patients Affected by Multimorbidity in Acute Hospitals. J Am Med Dir Assoc 2021; 23:885-888. [PMID: 34798007 DOI: 10.1016/j.jamda.2021.10.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Revised: 09/28/2021] [Accepted: 10/09/2021] [Indexed: 01/18/2023]
Abstract
OBJECTIVES Delirium is commonly seen in older adults with multimorbidity, during a hospitalization, resulting from the interplay between predisposing factors such as advanced age, frailty, and dementia, and a series of precipitating factors. The association between delirium and specific multimorbidity is largely unexplored so far although of potential key relevance for targeted interventions. The aim of the study was to check for a potential association of multimorbidity with delirium in a large cohort of older patients hospitalized for an acute medical or surgical condition. DESIGN This is a cross-sectional study nested in the 2017 Delirium Day project. SETTING AND PARTICIPANTS The study includes 1829 hospitalized patients (age: 81.8, SD: 5.5). Of them, 419 (22.9%) had delirium. METHODS Sociodemographic and medical history were collected. The 4AT was used to assess the presence of delirium. The Charlson Comorbidity index was used to assess multimorbidity. RESULTS The results identified neurosensorial multimorbidity as the most prevalent, including patients with dementia, cerebrovascular diseases, and sensory impairments. In light of the highest co-occurrence of 3 neurosensorial chronic conditions, we could hypothesize that a baseline altered brain functional and neural connectivity might determine the vulnerability signature for incipient overall system disruption in presence of acute insults. CONCLUSIONS AND IMPLICATIONS Eventually, our findings moved a step forward in supporting the key importance of routine screening for sensory impairments and cognitive status of older patients for the highest risk of in-hospital delirium. In fact, preventive interventions could be particularly relevant and effective in preventing delirium in such vulnerable populations and might help refining this early diagnosis.
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Wang J, Liu J, Lai K, Zhang Q, Zheng Y, Wang S, Liang M. Mirror Mechanism Behind Visual-Auditory Interaction: Evidence From Event-Related Potentials in Children With Cochlear Implants. Front Neurosci 2021; 15:692520. [PMID: 34504413 PMCID: PMC8421565 DOI: 10.3389/fnins.2021.692520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Accepted: 07/16/2021] [Indexed: 11/13/2022] Open
Abstract
The mechanism underlying visual-induced auditory interaction is still under discussion. Here, we provide evidence that the mirror mechanism underlies visual–auditory interactions. In this study, visual stimuli were divided into two major groups—mirror stimuli that were able to activate mirror neurons and non-mirror stimuli that were not able to activate mirror neurons. The two groups were further divided into six subgroups as follows: visual speech-related mirror stimuli, visual speech-irrelevant mirror stimuli, and non-mirror stimuli with four different luminance levels. Participants were 25 children with cochlear implants (CIs) who underwent an event-related potential (ERP) and speech recognition task. The main results were as follows: (1) there were significant differences in P1, N1, and P2 ERPs between mirror stimuli and non-mirror stimuli; (2) these ERP differences between mirror and non-mirror stimuli were partly driven by Brodmann areas 41 and 42 in the superior temporal gyrus; (3) ERP component differences between visual speech-related mirror and non-mirror stimuli were partly driven by Brodmann area 39 (visual speech area), which was not observed when comparing the visual speech-irrelevant stimulus and non-mirror groups; and (4) ERPs evoked by visual speech-related mirror stimuli had more components correlated with speech recognition than ERPs evoked by non-mirror stimuli, while ERPs evoked by speech-irrelevant mirror stimuli were not significantly different to those induced by the non-mirror stimuli. These results indicate the following: (1) mirror and non-mirror stimuli differ in their associated neural activation; (2) the visual–auditory interaction possibly led to ERP differences, as Brodmann areas 41 and 42 constitute the primary auditory cortex; (3) mirror neurons could be responsible for the ERP differences, considering that Brodmann area 39 is associated with processing information about speech-related mirror stimuli; and (4) ERPs evoked by visual speech-related mirror stimuli could better reflect speech recognition ability. These results support the hypothesis that a mirror mechanism underlies visual–auditory interactions.
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Affiliation(s)
- Junbo Wang
- Department of Otolaryngology, Sun Yat-sen Memorial Hospital, Guangzhou, China
| | - Jiahao Liu
- Department of Otolaryngology, Sun Yat-sen Memorial Hospital, Guangzhou, China
| | - Kaiyin Lai
- South China Normal University, Guangzhou, China
| | - Qi Zhang
- School of Foreign Languages, Shenzhen University, Shenzhen, China
| | - Yiqing Zheng
- Department of Otolaryngology, Sun Yat-sen Memorial Hospital, Guangzhou, China
| | | | - Maojin Liang
- Department of Otolaryngology, Sun Yat-sen Memorial Hospital, Guangzhou, China
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Reduced resting state functional connectivity with increasing age-related hearing loss and McGurk susceptibility. Sci Rep 2020; 10:16987. [PMID: 33046800 PMCID: PMC7550565 DOI: 10.1038/s41598-020-74012-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Accepted: 09/15/2020] [Indexed: 11/21/2022] Open
Abstract
Age-related hearing loss has been related to a compensatory increase in audio-visual integration and neural reorganization including alterations in functional resting state connectivity. How these two changes are linked in elderly listeners is unclear. The current study explored modulatory effects of hearing thresholds and audio-visual integration on resting state functional connectivity. We analysed a large set of resting state data of 65 elderly participants with a widely varying degree of untreated hearing loss. Audio-visual integration, as gauged with the McGurk effect, increased with progressing hearing thresholds. On the neural level, McGurk illusions were negatively related to functional coupling between motor and auditory regions. Similarly, connectivity of the dorsal attention network to sensorimotor and primary motor cortices was reduced with increasing hearing loss. The same effect was obtained for connectivity between the salience network and visual cortex. Our findings suggest that with progressing untreated age-related hearing loss, functional coupling at rest declines, affecting connectivity of brain networks and areas associated with attentional, visual, sensorimotor and motor processes. Especially connectivity reductions between auditory and motor areas were related to stronger audio-visual integration found with increasing hearing loss.
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Neuroanatomical changes associated with age-related hearing loss and listening effort. Brain Struct Funct 2020; 225:2689-2700. [PMID: 32960318 PMCID: PMC7674350 DOI: 10.1007/s00429-020-02148-w] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Accepted: 09/09/2020] [Indexed: 02/03/2023]
Abstract
Age-related hearing loss is associated with a decrease in hearing abilities for high frequencies and therefore leads to impairments in understanding speech—in particular, under adverse listening conditions. Growing evidence suggests that age-related hearing loss is related to various neural changes, for instance, affecting auditory and frontal brain regions. How the decreased auditory input and the increased listening effort in daily life are associated with structural changes is less clear, since previous evidence is scarce and mostly involved low sample sizes. Hence, the aim of the current study was to investigate the impact of age-related untreated hearing loss and subjectively rated daily life listening effort on grey matter and white matter changes in a large sample of participants (n = 71). For that aim, we conducted anatomical MRI and diffusion tensor imaging (DTI) in elderly hard-of-hearing and age-matched normal-hearing participants. Our results showed significantly lower grey matter volume in the middle frontal cortex in hard-of-hearing compared to normal-hearing participants. Further, higher listening effort was associated with lower grey matter volume and cortical thickness in the orbitofrontal cortex and lower grey matter volume in the inferior frontal cortex. No significant relations between hearing abilities or listening effort were obtained for white matter integrity in tracts connecting auditory and prefrontal as well as visual areas. These findings provide evidence that hearing impairment as well as daily life listening effort seems to be associated with grey matter loss in prefrontal brain regions. We further conclude that alterations in cortical thickness seem to be linked to the increased listening effort rather than the hearing loss itself.
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