Speech processing asymmetry revealed by dichotic listening and functional brain imaging

Dichotic listening and interhemispheric integration after callosotomy: A systematic review

The right-ear advantage (REA) for recalling dichotically presented auditory-verbal stimuli has been traditionally linked to the dominance of the left cerebral hemisphere for speech processing. Early studies on patients with callosotomy additionally found that the removal of the corpus callosum leads to a complete extinction of the left ear, and consequently the today widely used models to explain the REA assume a central role of callosal axons for recalling the left-ear stimulus in dichotic listening. However, later dichotic-listening studies on callosotomy patients challenge this interpretation, as many patients appear to be able to recall left-ear stimuli well above chance level, albeit with reduced accuracy. The aim of the present systematic review was to identify possible experimental and patient variables that explain the inconsistences found regarding the effect of split-brain surgery on dichotic listening. For this purpose, a systematic literature search was conducted (databases: Pubmed, Web of Knowledge, EBSChost, and Ovid) to identify all empirical studies on patients with surgical section of the corpus callosum (complete or partial) that used a verbal dichotic-listening paradigm. This search yielded ks = 32 publications reporting patient data either on case or group level, and the data was analysed by comparing the case-level incidence of left-ear suppression, left-ear extinction, and right-ear enhancement narratively or statistically considering possible moderator variables (i.a., extent of the callosal surgery, stimulus material, response format, selective attention). The main finding was an increased incidence of left-ear suppression (odds ratio = 7.47, CI95%: [1.21; 83.49], exact p = .02) and right-ear enhancement (odds ratio = 21.61, CI95%: [4.40; 154.11], p < .01) when rhyming as compared with non-rhyming stimuli were used. Also, an increase in left-ear reports was apparent when a response by the right hemisphere was allowed (i.e., response with the left hand). While the present review is limited by the overall small number of cases and a lack of an appropriate control sample in most of the original studies, the findings nevertheless suggest an adjustment of the classical dichotic-listening models incorporating right-hemispheric processing abilities as well as the perceptual competition of the left- and right-ear stimuli for attention.

Clinical implications of brain asymmetries

No two human brains are alike, and with the rise of precision medicine in neurology, we are seeing an increased emphasis on understanding the individual variability in brain structure and function that renders every brain unique. Functional and structural brain asymmetries are a fundamental principle of brain organization, and recent research suggests substantial individual variability in these asymmetries that needs to be considered in clinical practice. In this Review, we provide an overview of brain asymmetries, variations in such asymmetries and their relevance in the clinical context. We review recent findings on brain asymmetries in neuropsychiatric and neurodevelopmental disorders, as well as in specific learning disabilities, with an emphasis on large-scale database studies and meta-analyses. We also highlight the relevance of asymmetries for disease symptom onset in neurodegenerative diseases and their implications for lateralized treatments, including brain stimulation. We conclude that alterations in brain asymmetry are not sufficiently specific to act as diagnostic biomarkers but can serve as meaningful symptom or treatment response biomarkers in certain contexts. On the basis of these insights, we provide several recommendations for neurological clinical practice.

The Right-Ear Advantage in Static and Dynamic Cocktail-Party Situations

When presenting two competing speech stimuli, one to each ear, a right-ear advantage (REA) can often be observed, reflected in better speech recognition compared to the left ear. Considering the left-hemispheric dominance for language, the REA has been explained by superior contralateral pathways (structural models) and language-induced shifts of attention to the right (attentional models). There is some evidence that the REA becomes more pronounced, as cognitive load increases. Hence, it is interesting to investigate the REA in static (constant target talker) and dynamic (target changing pseudo-randomly) cocktail-party situations, as the latter is associated with a higher cognitive load than the former. Furthermore, previous research suggests an increasing REA, when listening becomes more perceptually challenging. The present study examined the REA by using virtual acoustics to simulate static and dynamic cocktail-party situations, with three spatially separated talkers uttering concurrent matrix sentences. Sentences were presented at low sound pressure levels or processed with a noise vocoder to increase perceptual load. Sixteen young normal-hearing adults participated in the study. The REA was assessed by means of word recognition scores and a detailed error analysis. Word recognition revealed a greater REA for the dynamic than for the static situations, compatible with the view that an increase in cognitive load results in a heightened REA. Also, the REA depended on the type of perceptual load, as indicated by a higher REA associated with vocoded compared to low-level stimuli. The results of the error analysis support both structural and attentional models of the REA.

When Age Tips the Balance: a Dual Mechanism Affecting Hemispheric Specialization for Language

Aging engenders neuroadaptations, generally reducing specificity and selectivity in functional brain responses. Our investigation delves into the functional specialization of brain hemispheres within language-related networks across adulthood. In a cohort of 728 healthy adults spanning ages 18 to 88, we modeled the trajectories of inter-hemispheric asymmetry concerning the principal functional gradient across 37 homotopic regions of interest (hROIs) of an extensive language network, known as the Language-and-Memory Network. Our findings reveal that over two-thirds of Language-and-Memory Network hROIs undergo asymmetry changes with age, falling into two main clusters. The first cluster evolves from left-sided specialization to right-sided tendencies, while the second cluster transitions from right-sided asymmetry to left-hemisphere dominance. These reversed asymmetry shifts manifest around midlife, occurring after age 50, and are associated with poorer language production performance. Our results provide valuable insights into the influence of functional brain asymmetries on language proficiency and present a dynamic perspective on brain plasticity during the typical aging process.

Hand Preference in Stuttering: Meta-Analyses

Reduced hemispheric asymmetries, as well as their behavioral manifestation in the form of atypical handedness (i.e., non-right, left-, or mixed-handedness), are linked to neurodevelopmental disorders, such as autism spectrum disorder, and several psychiatric disorders, such as schizophrenia. One neurodevelopmental disorder that is associated with reduced hemispheric asymmetries, but for which findings on behavioral laterality are conflicting, is stuttering. Here, we report a series of meta-analyses of studies that report handedness (assessed as hand preference) levels in individuals who stutter (otherwise healthy) compared to controls. For this purpose, articles were identified via a search in PubMed, Scopus, and PsycInfo (13 June 2023). On the basis of k = 52 identified studies totaling n = 2590 individuals who stutter and n = 17,148 controls, five random effects meta-analyses were conducted: four using the odds ratio [left-handers (forced choice); left-handers (extreme); mixed-handers; non-right-handers vs. total)] and one using the standardized difference in means as the effect size. We did not find evidence of a left (extreme)- or mixed-handedness difference or a difference in mean handedness scores, but evidence did emerge, when it came to left-handedness (forced-choice) and (inconclusively for) non-right-handedness. Risk-of-bias analysis was not deemed necessary in the context of these meta-analyses. Differences in hand skill or strength of handedness could not be assessed as no pertinent studies were located. Severity of stuttering could not be used s a moderator, as too few studies broke down their data according to severity. Our findings do not allow for firm conclusions to be drawn on whether stuttering is associated with reduced hemispheric asymmetries, at least when it comes to their behavioral manifestation.

Dichotic Sentences Test Performance of Adults with communication complaints

PURPOSE

To analyze the performance of normal-hearing adults with communication complaints in the Dichotic Sentences Test.

METHODS

We selected from the database 15 normal-hearing participants with normal results in the Digits Dichotic Test, aged between 19 and 44 years, right-handed, who reported communicative complaints. The Dichotic Sentences Test was applied using two protocols consisting of four different combinations of lists called sequences 1 and 2, in the following order: training, divided attention step, right and left directed attention steps.

RESULTS

In the first application sequence, the average performance in the divided attention step was 84.7% for the right ear and 60.67% for the left, with statistical difference between ears. The asymmetry between ears varied from -50% to 60%. In the directed attention step, the average performance was 99.33% for the right ear and 98% for the left, with no statistical difference. In the second application sequence, there was a tendency for better results, more pronounced for the left ear, with no statistical significance, with the performance variation and asymmetry between ears remaining high. In the comparison between the sequences, in the divided attention step, it was found that, for the right ear, 40% of the individuals did not vary, 33% performed worse, and 26.7% performed better; for the left ear, 6.6% did not vary, 20% performed worse, and 73.33% performed better. There was result stability in the directed attention step.

CONCLUSION

The normal-hearing adults with communication complaints presented a heterogeneous profile, especially in the divided attention step, with a marked difference between ears and response variability.

Effects of transcranial electrical stimulation techniques on foreign vocabulary learning

Although the use of transcranial electrical stimulation (tES) techniques on healthy population has been linked to facilitating language learning, studies on their effects on foreign language learning processes are scarce and results remain unclear. The objective of this study was to analyze whether tES enhances foreign language learning processes. Sixty-four healthy native Spanish-speaking participants were randomly assigned to four groups (transcranial direct current, transcranial random noise, tDCS-tRNS stimulation, or sham). They completed two intervention sessions with a two-week gap in between. During the first session the participants received stimulation (1.5 mA) while learning new English words and then performed recall and recognition tasks. Learning was assessed at follow-up, two weeks later. No differences in learning between groups were observed in the first session (F_(1,61)= .86; p = .36). At follow-up, significantly higher learning accuracy was observed after tRNS compared to sham (p = .037). These results suggest that tRNS could be helpful in improving the processes involved in foreign language vocabulary learning.

Speech Perception and Dichotic Listening Are Associated With Hearing Thresholds and Cognition, Respectively, in Unaided Presbycusis

Presbycusis or age-related hearing loss is a prevalent condition in the elderly population, which affects oral communication, especially in background noise, and has been associated with social isolation, depression, and cognitive decline. However, the mechanisms that relate hearing loss with cognition are complex and still elusive. Importantly, recent studies show that the use of hearing aids in presbycusis, which is its standard management, can induce neuroplasticity and modify performance in cognitive tests. As the majority of the previous studies on audition and cognition obtained their results from a mixed sample of subjects, including presbycusis individuals fitted and not fitted with hearing aids, here, we revisited the associations between hearing loss and cognition in a controlled sample of unaided presbycusis. We performed a cross-sectional study in 116 non-demented Chilean volunteers aged ≥65 years from the Auditory and Dementia study cohort. Specifically, we explored associations between bilateral sensorineural hearing loss, suprathreshold auditory brain stem responses, auditory processing (AP), and cognition with a comprehensive neuropsychological examination. The AP assessment included speech perception in noise (SIN), dichotic listening (dichotic digits and staggered spondaic words), and temporal processing [frequency pattern (FP) and gap-in-noise detection]. The neuropsychological evaluations included attention, memory, language, processing speed, executive function, and visuospatial abilities. We performed an exploratory factor analysis that yielded four composite factors, namely, hearing loss, auditory nerve, midbrain, and cognition. These four factors were used for generalized multiple linear regression models. We found significant models showing that hearing loss is associated with bilateral SIN performance, while dichotic listening was associated with cognition. We concluded that the comprehension of the auditory message in unaided presbycusis is a complex process that relies on audition and cognition. In unaided presbycusis with mild hearing loss (<40 dB HL), speech perception of monosyllabic words in background noise is associated with hearing levels, while cognition is associated with dichotic listening and FP.

The Predictive Value of Individual Electric Field Modeling for Transcranial Alternating Current Stimulation Induced Brain Modulation

There is considerable individual variability in the reported effectiveness of non-invasive brain stimulation. This variability has often been ascribed to differences in the neuroanatomy and resulting differences in the induced electric field inside the brain. In this study, we addressed the question whether individual differences in the induced electric field can predict the neurophysiological and behavioral consequences of gamma band tACS. In a within-subject experiment, bi-hemispheric gamma band tACS and sham stimulation was applied in alternating blocks to the participants' superior temporal lobe, while task-evoked auditory brain activity was measured with concurrent functional magnetic resonance imaging (fMRI) and a dichotic listening task. Gamma tACS was applied with different interhemispheric phase lags. In a recent study, we could show that anti-phase tACS (180° interhemispheric phase lag), but not in-phase tACS (0° interhemispheric phase lag), selectively modulates interhemispheric brain connectivity. Using a T1 structural image of each participant's brain, an individual simulation of the induced electric field was computed. From these simulations, we derived two predictor variables: maximal strength (average of the 10,000 voxels with largest electric field values) and precision of the electric field (spatial correlation between the electric field and the task evoked brain activity during sham stimulation). We found considerable variability in the individual strength and precision of the electric fields. Importantly, the strength of the electric field over the right hemisphere predicted individual differences of tACS induced brain connectivity changes. Moreover, we found in both hemispheres a statistical trend for the effect of electric field strength on tACS induced BOLD signal changes. In contrast, the precision of the electric field did not predict any neurophysiological measure. Further, neither strength, nor precision predicted interhemispheric integration. In conclusion, we found evidence for the dose-response relationship between individual differences in electric fields and tACS induced activity and connectivity changes in concurrent fMRI. However, the fact that this relationship was stronger in the right hemisphere suggests that the relationship between the electric field parameters, neurophysiology, and behavior may be more complex for bi-hemispheric tACS.

Handedness in ADHD: Meta-Analyses

Meta-analyses have shown that several neurodevelopmental and psychiatric disorders, such as autism spectrum disorder and schizophrenia, are associated with a higher prevalence of atypical (left-, non-right-, or mixed-) handedness. One neurodevelopmental disorder for which this association is unclear is attention deficit hyperactivity disorder (ADHD). Here, some empirical studies have found evidence for a higher prevalence of atypical handedness in individuals with ADHD compared to neurotypical individuals. However, other studies failed to establish such an association. Therefore, meta-analytic integration is critical to estimate whether or not there is an association between handedness and ADHD. We report the results of three meta-analyses (left-, mixed-, and non-right-handedness) comparing handedness in individuals with ADHD to controls (typically developing individuals). The results show evidence of a trend towards elevated levels of atypical handedness when it comes to differences in left- and mixed-handedness (p = 0.09 and p = 0.07, respectively), but do show clear evidence of elevated levels of non-right-handedness between individuals with ADHD and controls (p = 0.02). These findings are discussed in the context of the hypothesis that ADHD is a disorder in which mostly right-hemispheric brain networks are affected. Since right-handedness represents a dominance of the left motor cortex for fine motor behavior, such as writing, as well as a left-hemispheric dominance for language functions, and about 90% of individuals are right-handers, this hypothesis might explain why there is not stronger evidence for an association of left-handedness with ADHD. We suggest that the mechanisms involved in the pathogenesis of ADHD might show an overlap with the mechanisms involved in handedness strength, but not handedness direction.

Combined fMRI Region- and Network-Analysis Reveal New Insights of Top-Down Modulation of Bottom-Up Processes in Auditory Laterality

Dichotic listening along with the right-ear advantage (REA) has been a standard method of investigating auditory laterality ever since it was first introduced into neuropsychology in the early 1960s. Beginning in the 1980s, authors reported that it was possible to modulate the bottom-up driven perceptual REA by instructing subjects to selectively attend to and report only from the right or left ear. In the present study, we investigated neuronal correlates of both the bottom-up and top-down modulation of the REA through two fMRI analysis approaches: a traditional region approach and a network connectivity approach. Blood-Oxygenation-Level-Dependent (BOLD) fMRI data were acquired while subjects performed the standard forced-attention paradigm. We asked two questions, could the behavioral REA be replicated in unique brain markers, and second if the profound instruction-induced modulation of the REA found in behavioral data would correspond to a similar modulation of brain activation, both region- and network-specific modulations. The subjects were 70 healthy adult right-handers, about half men and half women. fMRI data were acquired in a 3T MR scanner, and the behavioral results replicated previous findings with a REA in the non-forced (NF) and forced-right (FR) conditions, and a tendency for a left-ear advantage (LEA) in the FL-condition. The fMRI data showed unique activations in the speech perception areas of the left temporal lobe when directly contrasted with activations in the homologous right side. However, there were no remaining unique activations when the FR- and FL-conditions were contrasted against each other, and with the NF-condition, using a conservative significance thresholding. The fMRI results are conceptualized within a network connectivity frame of reference, especially with reference to the extrinsic mode network (EMN). The EMN is a generalized task-positive network that is upregulated whenever the task demands exceed a certain threshold irrespective of the specifics and demands of the task. This could explain the similarity of activations for the FR- and FL-conditions, despite the clear differences in behavior.

Is it left or is it right? A classification approach for investigating hemispheric differences in low and high dimensionality

Hemispheric asymmetries, i.e., differences between the two halves of the brain, have extensively been studied with respect to both structure and function. Commonly employed pairwise comparisons between left and right are suitable for finding differences between the hemispheres, but they come with several caveats when assessing multiple asymmetries. What is more, they are not designed for identifying the characterizing features of each hemisphere. Here, we present a novel data-driven framework—based on machine learning-based classification—for identifying the characterizing features that underlie hemispheric differences. Using voxel-based morphometry data from two different samples (n = 226, n = 216), we separated the hemispheres along the midline and used two different pipelines: First, for investigating global differences, we embedded the hemispheres into a two-dimensional space and applied a classifier to assess if the hemispheres are distinguishable in their low-dimensional representation. Second, to investigate which voxels show systematic hemispheric differences, we employed two classification approaches promoting feature selection in high dimensions. The two hemispheres were accurately classifiable in both their low-dimensional (accuracies: dataset 1 = 0.838; dataset 2 = 0.850) and high-dimensional (accuracies: dataset 1 = 0.966; dataset 2 = 0.959) representations. In low dimensions, classification of the right hemisphere showed higher precision (dataset 1 = 0.862; dataset 2 = 0.894) compared to the left hemisphere (dataset 1 = 0.818; dataset 2 = 0.816). A feature selection algorithm in the high-dimensional analysis identified voxels that most contribute to accurate classification. In addition, the map of contributing voxels showed a better overlap with moderate to highly lateralized voxels, whereas conventional t test with threshold-free cluster enhancement best resembled the LQ map at lower thresholds. Both the low- and high-dimensional classifiers were capable of identifying the hemispheres in subsamples of the datasets, such as males, females, right-handed, or non-right-handed participants. Our study indicates that hemisphere classification is capable of identifying the hemisphere in their low- and high-dimensional representation as well as delineating brain asymmetries. The concept of hemisphere classifiability thus allows a change in perspective, from asking what differs between the hemispheres towards focusing on the features needed to identify the left and right hemispheres. Taking this perspective on hemispheric differences may contribute to our understanding of what makes each hemisphere special.

Dichotic listening performance and interhemispheric integration after administration of hydrocortisone

Chronic stress has been shown to have long-term effects on functional hemispheric asymmetries in both humans and non-human species. The short-term effects of acute stress exposure on functional hemispheric asymmetries are less well investigated. It has been suggested that acute stress can affect functional hemispheric asymmetries by modulating inhibitory function of the corpus callosum, the white matter pathway that connects the two hemispheres. On the molecular level, this modulation may be caused by a stress-related increase in cortisol, a major stress hormone. Therefore, it was the aim of the present study to investigate the acute effects of cortisol on functional hemispheric asymmetries. Overall, 60 participants were tested after administration of 20 mg hydrocortisone or a placebo tablet in a cross-over design. Both times, a verbal and an emotional dichotic listening task to assess language and emotional lateralization, as well as a Banich-Belger task to assess interhemispheric integration were applied. Lateralization quotients were determined for both reaction times and correctly identified syllables in both dichotic listening tasks. In the Banich-Belger task, across-field advantages were determined to quantify interhemispheric integration. While we could replicate previously reported findings for these tasks in the placebo session, we could not detect any differences in asymmetry between hydrocortisone and placebo treatment. This partially corroborates the results of a previous study we performed using social stress to induce cortisol increases. This suggests that an increase in cortisol does not influence dichotic listening performance on a behavioral level. As other studies reported an effect of stress hormones on functional hemispheric asymmetries on a neuro-functional level, future research using neuronal imaging methods would be helpful in the characterization of the relation of hemispheric asymmetries and stress hormones.

Executive Function and Sensory Processing in Dichotic Listening of Young Adults with Listening Difficulties

Previous studies have suggested that varying attention demands in dichotic listening (DL) tasks might be a clinically feasible method to distinguish ‘bottom-up’ from ‘top-down’ deficits in listening. This study aims to investigate DL processing in adults with listening difficulties (LD). We assessed the performance of a listening difficulties group (LDG) (n = 24, mean age = 24, backward digit span = 4.0) and a control group (CG) (n = 25, mean age = 29.2, backward digit span = 6.4) in DL tests involving non-forced and both right and left-forced attention. The results indicated an overall significantly worse performance of LDG compared to the CG, which was greater for forced-left condition. This same result was observed when controlling for working memory (WM) variance. Both groups presented an overall right ear advantage with no difference in terms of the magnitude of advantage. These results indicate that LD presented by the LDG might be due to a combination of sensory and cognitive deficits, with emphasis on the cognitive component. However, the WM, although impaired in the LDG group, was not the main factor in segregating both groups. The role of the additional cognitive processes such as inhibitory control in LD is discussed.

Auditory processing in schizophrenia: Behavioural evidence of abnormal spatial awareness

Spatial processing deficits are the reason for many daily life problems of schizophrenia (SCZ) patients. In this study, we aimed to examine the possibility of abnormal bias to one hemifield, in form of hemispatial neglect and extinction, in auditory modality in SCZ. Twenty-five SCZ patients and 25 healthy individuals were compared on speech tasks to study the auditory neglect and extinction, as well as an auditory localization task for studying neglect. In the speech tasks, participants reproduced some nonsense syllables, played from one or two speakers on the right and/or left sides. On the localization task, examinees discriminated the subjective location of the noise stimuli presented randomly from five speakers. On the speech task, patients had significantly lower hit rates for the right ear compared with controls (p = 0.01). While healthy controls showed right ear advantage, SCZs showed a left ear priority. In the localization task, although both groups had a left-side bias, this bias was much more prominent for the patients (all p < 0.05). SCZ could potentially alter the auditory spatial function, which may appear in the form of auditory neglect and extinction on the right side, depending on the characteristics of patient population.

Neuroplasticity during the transition period: How the adolescent brain can recover from aphasia. A pilot study

BACKGROUND

Increasing clinical and scientific attention is given to the transition of neurological stages from child to adult. Data on brain plasticity during adolescence is interesting for providing adequate evidence-based medical attention to neurological conditions in this population. Acquired aphasia is well described in adults and children, but not in adolescence.

OBJECTIVE

We describe a 5-year follow-up of language in three adolescent subjects with post-brain injury aphasia.

METHODS

We analysed and scored formal aspects of language three times, language hemispheric dominance twice with dichotic listening test and functional magnetic resonance imaging (fMRI) brain activation patterns that supported expressive and comprehensive language during the recovery period.

RESULTS

We found similarities to both paediatric and adult aphasia in these three adolescents. While the level of recovery resembled that of children with aphasia, a more efficient language rehabilitation occurred in those who remained with left hemispheric dominance in the chronic stage, as it is reported in adults.

CONCLUSIONS

Our analysis and long-term follow-up provide data for a better understanding on how the injured brain matures during adolescence. More studies with larger samples will help to understand the function of the remaining networks and the recovery from injury in this particular age group.

Selective modulation of interhemispheric connectivity by transcranial alternating current stimulation influences binaural integration

Brain connectivity plays a major role in the encoding, transfer, and integration of sensory information. Interregional synchronization of neural oscillations in the γ-frequency band has been suggested as a key mechanism underlying perceptual integration. In a recent study, we found evidence for this hypothesis showing that the modulation of interhemispheric oscillatory synchrony by means of bihemispheric high-density transcranial alternating current stimulation (HD-TACS) affects binaural integration of dichotic acoustic features. Here, we aimed to establish a direct link between oscillatory synchrony, effective brain connectivity, and binaural integration. We experimentally manipulated oscillatory synchrony (using bihemispheric γ-TACS with different interhemispheric phase lags) and assessed the effect on effective brain connectivity and binaural integration (as measured with functional MRI and a dichotic listening task, respectively). We found that TACS reduced intrahemispheric connectivity within the auditory cortices and antiphase (interhemispheric phase lag 180°) TACS modulated connectivity between the two auditory cortices. Importantly, the changes in intra- and interhemispheric connectivity induced by TACS were correlated with changes in perceptual integration. Our results indicate that γ-band synchronization between the two auditory cortices plays a functional role in binaural integration, supporting the proposed role of interregional oscillatory synchrony in perceptual integration.

Relations between hemispheric asymmetries of grey matter and auditory processing of spoken syllables in 281 healthy adults

Most people have a right-ear advantage for the perception of spoken syllables, consistent with left hemisphere dominance for speech processing. However, there is considerable variation, with some people showing left-ear advantage. The extent to which this variation is reflected in brain structure remains unclear. We tested for relations between hemispheric asymmetries of auditory processing and of grey matter in 281 adults, using dichotic listening and voxel-based morphometry. This was the largest study of this issue to date. Per-voxel asymmetry indexes were derived for each participant following registration of brain magnetic resonance images to a template that was symmetrized. The asymmetry index derived from dichotic listening was related to grey matter asymmetry in clusters of voxels corresponding to the amygdala and cerebellum lobule VI. There was also a smaller, non-significant cluster in the posterior superior temporal gyrus, a region of auditory cortex. These findings contribute to the mapping of asymmetrical structure–function links in the human brain and suggest that subcortical structures should be investigated in relation to hemispheric dominance for speech processing, in addition to auditory cortex.

Dichotic listening performance and interhemispheric integration after stress exposure

Functional hemispheric asymmetries (FHAs) have been thought to be relatively stable over time. However, past research has shown that FHAs are more plastic than initially thought. Endocrinological processes have been demonstrated to alter FHAs. As the product of the stress-activated hypothalamus–pituitary–adrenal axis, cortisol influences information processing at every level from stimulus perception to decision making and action. To investigate the influence of acute stress on FHAs, 60 participants performed a Banich–Belger task, as well as a verbal and an emotional dichotic listening task in two sessions. One session included a stress induction via the Trier Social Stress Test, the other session included a control procedure. We calculated across-field advantages (AFAs) in the Banich–Belger task and lateralization quotients for reaction times and responses per side in both dichotic listening tasks. There were no significant differences between the stress and control session in the dichotic listening tasks. In contrast, there was evidence for an influence of cortisol and sympathetic activation indicated by salivary alpha amylase changes on AFAs in the Banich–Belger task. This indicates that acute stress and the related increase in cortisol do not influence dichotic listening performance. However, stress does seem to affect interhemispheric integration of information. Future research using EEG, fMRI and pharmacological interventions is needed to further characterize the relation of hemispheric asymmetries and acute stress.

VR Glasses based Measurement of Responses to Dichoptic Stimuli: A Potential Tool for Quantifying Amblyopia?

Amblyopia is a medical condition in which the visual inputs from one of the eyes is suppressed by the brain. This leads to reduced visual acuity and poor or complete loss of stereopsis. Conventional clinical tests such as Worth 4-dot test and Bagolini striated lens test can only detect the presence of suppression but cannot quantify the extent of suppression, which is important for identifying the effectiveness of treatments for amblyopia. A novel approach for quantifying the level of suppression in amblyopia is proposed in this paper. We hypothesize that the level of suppression in amblyopia can be measured by measuring the symmetry/asymmetry in the suppression experienced during a dichoptic image recognition task. Preliminary studies done on fifty one normal subjects prove that the differences between the accuracies of the left and right eyes can be used as a measure of asymmetry. Equivalence test performed using 'two-one-sided t-tests' procedure shows that the equivalence of the accuracies of left and right eyes for normal subjects is statistically significant (p = .03, symmetric equivalence margin of 5 percentage points). To validate this method, six amblyopic children underwent this test and the results obtained are promising. To the knowledge of the authors, this is the first work to make use of VR glasses and dichoptic image recognition task for quantifying the level of ocular suppression in amblyopic patients.

The role of left vs. right superior temporal gyrus in speech perception: An fMRI-guided TMS study

Debate continues regarding the necessary role of right superior temporal gyrus (STG) regions in sublexical speech perception given the bilateral STG activation often observed in fMRI studies. To evaluate the causal roles, TMS pulses were delivered to inhibit and disrupt neuronal activity at the left and right STG regions during a nonword discrimination task based on peak activations from a blocked fMRI paradigm assessing speech vs. nonspeech perception (N = 20). Relative to a control region located in the posterior occipital lobe, TMS to the left anterior STG (laSTG) led to significantly worse accuracy, whereas TMS to the left posterior STG (lpSTG) and right anterior STG (raSTG) did not. Although the disruption from TMS was significantly greater for the laSTG than for raSTG, the difference in accuracy between the laSTG and lpSTG did not reach significance. The results argue for a causal role of the laSTG but not raSTG in speech perception. Further research is needed to establish the source of the differences between the laSTG and lpSTG.

Dichotic listening while walking: A dual-task paradigm examining gait asymmetries in healthy older and younger adults

Dual-task studies have employed various cognitive tasks to evaluate the relationship between gait and cognition. Most of these tests are not specific to a single cognitive ability or sensory modality and have limited ecological validity. In this study, we employed a dual-task paradigm using Dichotic Listening (DL) as concomitant cognitive task to walking. We argue that DL is a robust task to unravel the gait-cognition link in different healthy populations of different age groups. Thirty-six healthy older adults (Mean = 67.11) and forty younger adults (Mean = 22.75) participated in the study. DL consists of three conditions where spontaneous attention and attention directed to right or left-ear are tested while walking. We calculated dual-task costs (DTCs) and percent of baseline values for three spatio-temporal gait parameters as compared to single-walking during three DL conditions. Results showed that both groups had larger DTCs on gait during volitional control of attention, i.e., directing attention to one specific ear. Group differences were present across all DL conditions where older adults reported consistently less correct stimuli than younger participants. Similar findings were observed in the neuropsychological battery where older participants showed restricted abilities for executive functioning and processing speed. However, the main finding of this investigation was that younger adults exhibited unique adjustments in step length variability as shown by changes in DTCs and percent of baseline values. Particularly, an asymmetric effect was observed on the young group when attending right-ear stimuli. We interpreted this gait asymmetry as a compensatory outcome in the younger participants due to their optimal perceptual and motor abilities, which allow them to cope suitably with the dual-task situation. Many studies suggest that gait asymmetries are indicators of pathology, the present data demonstrate that gait asymmetries arise under specific constraints in healthy people as an adaptation to task requirements.

Left Ear Hearing Predicts Functional Activity in the Brains of Patients with Alzheimer's Disease Dementia

OBJECTIVES

To determine whether central speech processing ability, as measured by hearing in noise, differs between right and left ears in adults with Alzheimer's disease related dementia (AD) as well as whether differences in central speech processing ability correlate with an fMRI-based measurement of global functional brain connectivity.

METHODS

This prospective study was carried out at a tertiary referral center. Patients with an AD diagnosis and pure tone averages 40 dB HL or better were included. They were examined using resting-state fMRI and underwent central audiometric testing using the Dichotic Sentence Identification Test (DSI), the Dichotic Digits Test (DD), and the Synthetic Sentence Identification Test (SS), which test hearing in noise. DSI scores were correlated with resting-state fMRI connectivity between 361 distinct gray matter brain regions of interest (ROIs). Average global connectivity was calculated as mean functional connectivity between an ROI and the other 360 regions, a quantitative marker representing overall functional connectivity in the brain.

RESULTS

Sixteen subjects had adequate fMRI and hearing data. The average age was 71.5 years old (±6.0). The average DSI score for the left ear was 40% (±34%) compared to 90% (±10%) in the right ear (P < .001). No difference between ears was noted on the DD. SS does not differentiate between ears, but worsening scores were noted with increasing background noise. Of the fMRI ROIs, 269 of the 361 had multiple comparison corrected significant correlations between global connectivity and DSI of the left ear (P = .004, r = .673), and all 269 showed higher functional connectivity for individuals with higher left DSI score. No correlations between DSI of the right ear and functional connectivity were found.

CONCLUSIONS

Correlation was noted between left sided DSI and functional connectivity in patients with AD. Auditory input from the left ear was more susceptible to impairment, suggesting that side-specific auditory input may influence central auditory processing.

Brain Lateralization: A Comparative Perspective

Comparative studies on brain asymmetry date back to the 19th century but then largely disappeared due to the assumption that lateralization is uniquely human. Since the reemergence of this field in the 1970s, we learned that left-right differences of brain and behavior exist throughout the animal kingdom and pay off in terms of sensory, cognitive, and motor efficiency. Ontogenetically, lateralization starts in many species with asymmetrical expression patterns of genes within the Nodal cascade that set up the scene for later complex interactions of genetic, environmental, and epigenetic factors. These take effect during different time points of ontogeny and create asymmetries of neural networks in diverse species. As a result, depending on task demands, left- or right-hemispheric loops of feedforward or feedback projections are then activated and can temporarily dominate a neural process. In addition, asymmetries of commissural transfer can shape lateralized processes in each hemisphere. It is still unclear if interhemispheric interactions depend on an inhibition/excitation dichotomy or instead adjust the contralateral temporal neural structure to delay the other hemisphere or synchronize with it during joint action. As outlined in our review, novel animal models and approaches could be established in the last decades, and they already produced a substantial increase of knowledge. Since there is practically no realm of human perception, cognition, emotion, or action that is not affected by our lateralized neural organization, insights from these comparative studies are crucial to understand the functions and pathologies of our asymmetric brain.

Do patients with hallucinations imagine speech right?

A direct relationship between auditory verbal hallucinations (AVHs) and decreased left-hemispheric lateralization in speech perception has been often described, although it has not been conclusively proven. The specific lateralization of AVHs has been poorly explored. However, patients with verbal hallucinations show a weak Right Ear Advantage (REA) in verbal perception compared to non AVHs listeners suggesting that left-hemispheric language area are involved in AVHs. In the present study, 29 schizophrenia patients with AVHs, 31 patients with psychotic bipolar disorder who experienced frequent AVHs, 27 patients with schizophrenia who had never experienced AVHs and 57 healthy controls were required to imagine hearing a voice in one ear alone. In line with previous evidence healthy controls confirmed the expected REA for auditory imagery, and the same REA was also found in non-hallucinator patients. However, in line with our hypothesis, patients with schizophrenia and psychotic bipolar disorder with AVHs showed no lateral bias. Results extend the relationship between abnormal asymmetry for verbal stimuli and AVHs to verbal imagery, suggesting that atypical verbal imagery may reflect a disruption of inter-hemispheric connectivity between areas implicated in the generation and monitoring of verbal imagery and may be predictive of a predisposition for AVHs. Results also indicate that the relationship between AVHs and hemispheric lateralization for auditory verbal imagery is not specific to schizophrenia but may extend to other disorders as well.

An optimal dichotic-listening paradigm for the assessment of hemispheric dominance for speech processing

Dichotic-listening paradigms are widely accepted as non-invasive tests of hemispheric dominance for language processing and represent a standard diagnostic tool for the assessment of developmental auditory and language disorders. Despite its popularity in research and clinical settings, dichotic paradigms show comparatively low reliability, significantly threatening the validity of conclusions drawn from the results. Thus, the aim of the present work was to design and evaluate a novel, highly reliable dichotic-listening paradigm for the assessment of hemispheric differences. Based on an extensive literature review, the paradigm was optimized to account for the main experimental variables which are known to systematically bias task performance or affect random error variance. The main design principle was to minimize the relevance of higher cognitive functions on task performance in order to obtain stimulus-driven laterality estimates. To this end, the key design features of the paradigm were the use of stop-consonant vowel (CV) syllables as stimulus material, a single stimulus pair per trial presentation mode, and a free recall (single) response instruction. Evaluating a verbal and manual response-format version of the paradigm in a sample of N = 50 healthy participants, we yielded test-retest intra-class correlations of rICC = .91 and .93 for the two response format versions. These excellent reliability estimates suggest that the optimal paradigm may offer an effective and efficient alternative to currently used paradigms both in research and diagnostic.

Listening Difficulties in Children: Behavior and Brain Activation Produced by Dichotic Listening of CV Syllables

Listening difficulties (LiD) are common in children with and without hearing loss. Impaired interactions between the two ears have been proposed as an important component of LiD when there is no hearing loss, also known as auditory processing disorder (APD). We examined the ability of 6-13 year old (y.o.) children with normal audiometric thresholds to identify and selectively attend to dichotically presented CV syllables using the Bergen Dichotic Listening Test (BDLT; www.dichoticlistening.com). Children were recruited as typically developing (TD; n = 39) or having LiD (n = 35) based primarily on composite score of the ECLiPS caregiver report. Different single syllables (ba, da, ga, pa, ta, ka) were presented simultaneously to each ear (6 × 36 trials). Children reported the syllable heard most clearly (non-forced, NF) or the syllable presented to the right [forced right (FR)] or left [forced left (FL)] ear. Interaural level differences (ILDs) manipulated bottom-up perceptual salience. Dichotic listening (DL) data [correct responses, laterality index (LI)] were analyzed initially by group (LiD, TD), age, report method (NF, FR, FL), and ILD (0, ± 15 dB) and compared with speech-in-noise thresholds (LiSN-S) and cognitive performance (NIH Toolbox). fMRI measured brain activation produced by a receptive speech task that segregated speech, phonetic, and intelligibility components. Some activated areas [planum temporale (PT), inferior frontal gyrus (IFG), and orbitofrontal cortex (OFC)] were correlated with dichotic results in TD children only. Neither group, age, nor report method affected the LI of right/left recall. However, a significant interaction was found between ear, group, and ILD. Laterality indices were small and tended to increase with age, as previously reported. Children with LiD had significantly larger mean LIs than TD children for stimuli with ILDs, especially those favoring the left ear. Neural activity associated with Speech, Phonetic, and Intelligibility sentence cues did not differ significantly between groups. Significant correlations between brain activity level and BDLT were found in several frontal and temporal locations for the TD but not for the LiD group. Overall, the children with LiD had only subtle differences from TD children in the BDLT, and correspondingly minor changes in brain activation.

Lateralization in the dichotic listening of tones is influenced by the content of speech

Cognitive functions, for example speech processing, are distributed asymmetrically in the two hemispheres that mostly have homologous anatomical structures. Dichotic listening is a well-established paradigm to investigate hemispherical lateralization of speech. However, the mixed results of dichotic listening, especially when using tonal languages as stimuli, complicates the investigation of functional lateralization. We hypothesized that the inconsistent results in dichotic listening are due to an interaction in processing a mixture of acoustic and linguistic attributes that are differentially processed over the two hemispheres. In this study, a within-subject dichotic listening paradigm was designed, in which different levels of speech and linguistic information was incrementally included in different conditions that required the same tone identification task. A left ear advantage (LEA), in contrast with the commonly found right ear advantage (REA) in dichotic listening, was observed in the hummed tones condition, where only the slow frequency modulation of tones was included. However, when phonemic and lexical information was added in simple vowel tone conditions, the LEA became unstable. Furthermore, ear preference became balanced when phonological and lexical-semantic attributes were included in the consonant-vowel (CV), pseudo-word, and word conditions. Compared with the existing REA results that use complex vowel word tones, a complete pattern emerged gradually shifting from LEA to REA. These results support the hypothesis that an acoustic analysis of suprasegmental information of tones is preferably processed in the right hemisphere, but is influenced by phonological and lexical semantic processes residing in the left hemisphere. The ear preference in dichotic listening depends on the levels of speech and linguistic analysis and preferentially lateralizes across the different hemispheres. That is, the manifestation of functional lateralization depends on the integration of information across the two hemispheres.

Asymmetrical Brain Plasticity: Physiology and Pathology

The brain is inherently asymmetrical. How that attribute, manifest both structurally (volumetric, cytological, molecular) as well as functionally, relates to cognitive function, is not fully understood. Since the early descriptions of Paul Broca and Marc Dax it has been known that the processing of language in the brain is fundamentally asymmetrical. Contemporary imaging studies have corroborated early observations, and have also revealed significant functional links to multiple other systems, such as those sub serving memory or emotion. Recent studies have demonstrated that laterality is both plastic and adaptive. Learning and training have shown to affect regional changes in asymmetry, such as that observed in the volume of the planum temporale associated with musical practice. Increasing task complexity has been demonstrated to induce recruitment of contralateral regions, suggesting that laterality is a manifestation of functional reserve. Indeed, in terms of cognitive function, successful aging is often associated with a reduction of asymmetrical activity. The goal of this review is to survey and critically appraise the current literature addressing brain laterality, both morphological and functional, with particular emphasis on the asymmetrical plasticity associated with environmental factors and training. The plastic recruitment of contralateral areas associated with aging and unilateral lesions will be discussed in the context of the loss of asymmetry as a compensatory mechanism, and specific instances of maladaptive plasticity will be explored.

Anatomo-functional correlates of auditory development in infancy

Infant brain development incorporates several intermingled mechanisms leading to intense and asynchronous maturation across cerebral networks and functional modalities. Combining electroencephalography (EEG) and diffusion magnetic resonance imaging (MRI), previous studies in the visual modality showed that the functional maturation of the event-related potentials (ERP) during the first postnatal semester relates to structural changes in the corresponding white matter pathways. Here investigated similar issues in the auditory modality. We measured ERPs to syllables in 1- to 6-month-old infants and related them to the maturational properties of underlying neural substrates measured with diffusion tensor imaging (DTI). We first observed a decrease in the latency of the auditory P2, and in the diffusivities in the auditory tracts and perisylvian regions with age. Secondly, we highlighted some of the early functional and structural substrates of lateralization. Contralateral responses to monoaural syllables were stronger and faster than ipsilateral responses, particularly in the left hemisphere. Besides, the acoustic radiations, arcuate fasciculus, middle temporal and angular gyri showed DTI asymmetries with a more complex and advanced microstructure in the left hemisphere, whereas the reverse was observed for the inferior frontal and superior temporal gyri. Finally, after accounting for the age-related variance, we correlated the inter-individual variability in P2 responses and in the microstructural properties of callosal fibers and inferior frontal regions. This study combining dedicated EEG and MRI approaches in infants highlights the complex relation between the functional responses to auditory stimuli and the maturational properties of the corresponding neural network.

Functional Connectivity of Heschl's Gyrus Associated With Age-Related Hearing Loss: A Resting-State fMRI Study

A large proportion of older adults experience hearing loss. Yet, the impact of hearing loss on the aging brain, particularly on large-scale brain networks that support cognition and language, is relatively unknown. We used resting-state functional magnetic resonance imaging (fMRI) to identify hearing loss-related changes in the functional connectivity of primary auditory cortex to determine if these changes are distinct from age and cognitive measures known to decline with age (e.g., working memory and processing speed). We assessed the functional connectivity of Heschl's gyrus in 31 older adults (60-80 years) who expressed a range of hearing abilities from normal hearing to a moderate hearing loss. Our results revealed that both left and right Heschl's gyri were significantly connected to regions within auditory, sensorimotor, and visual cortices, as well as to regions within the cingulo-opercular network known to support attention. Participant age, working memory, and processing speed did not significantly correlate with any connectivity measures once variance due to hearing loss was removed. However, hearing loss was associated with increased connectivity between right Heschl's gyrus and the dorsal anterior cingulate in the cingulo-opercular network even once variance due to age, working memory, and processing speed was removed. This greater connectivity was not driven by high frequency hearing loss, but rather by hearing loss measured in the 0.5-2 kHz range, particularly in the left ear. We conclude that hearing loss-related differences in functional connectivity in older adults are distinct from other aging-related differences and provide insight into a possible neural mechanism of compensation for hearing loss in older adults.

Bilateral Gamma/Delta Transcranial Alternating Current Stimulation Affects Interhemispheric Speech Sound Integration

Perceiving speech requires the integration of different speech cues, that is, formants. When the speech signal is split so that different cues are presented to the right and left ear (dichotic listening), comprehension requires the integration of binaural information. Based on prior electrophysiological evidence, we hypothesized that the integration of dichotically presented speech cues is enabled by interhemispheric phase synchronization between primary and secondary auditory cortex in the gamma frequency band. We tested this hypothesis by applying transcranial alternating current stimulation (TACS) bilaterally above the superior temporal lobe to induce or disrupt interhemispheric gamma-phase coupling. In contrast to initial predictions, we found that gamma TACS applied in-phase above the two hemispheres (interhemispheric lag 0°) perturbs interhemispheric integration of speech cues, possibly because the applied stimulation perturbs an inherent phase lag between the left and right auditory cortex. We also observed this disruptive effect when applying antiphasic delta TACS (interhemispheric lag 180°). We conclude that interhemispheric phase coupling plays a functional role in interhemispheric speech integration. The direction of this effect may depend on the stimulation frequency.

White matter correlates of gait perturbations resulting from spontaneous and lateralized attention in healthy older adults: A dual-task study

To date the neural mechanisms behind gait perturbations caused by dual-task paradigms are still unknown. Therefore, the present study examined white matter correlates of gait perturbations caused by a dichotic listening task where spontaneous (free focus of attention) and lateralized attentional control (voluntary attention directed to right or left-ear) were tested. Fifty-nine right-handed, healthy older adults (59-88 years) were evaluated during single-task walking and three dual-task conditions. Dual-task costs were calculated for mean (DTCM) and coefficients of variation (DTCCoV) in gait speed, step length, stride length and step width. Volume, fractional anisotropy and mean diffusivity were estimated using global probabilistic tractography for the 18 major brain tracts and correlated with the DTCs. Data demonstrated that DTCs on gait speed and step length significantly correlated with white matter integrity and volume in various tracts. Perturbations on gait speed caused by spontaneous attention were related to frontal circuitry integrity including corpus callosum, while perturbations on gait speed and step length produced by voluntary lateralized attention were associated to tracts subserving visuomotor integration and frontal function.

Language beyond the language system: Dorsal visuospatial pathways support processing of demonstratives and spatial language during naturalistic fast fMRI

Spatial demonstratives are powerful linguistic tools used to establish joint attention. Identifying the meaning of semantically underspecified expressions like "this one" hinges on the integration of linguistic and visual cues, attentional orienting and pragmatic inference. This synergy between language and extralinguistic cognition is pivotal to language comprehension in general, but especially prominent in demonstratives. In this study, we aimed to elucidate which neural architectures enable this intertwining between language and extralinguistic cognition using a naturalistic fMRI paradigm. In our experiment, 28 participants listened to a specially crafted dialogical narrative with a controlled number of spatial demonstratives. A fast multiband-EPI acquisition sequence (TR = 388 m s) combined with finite impulse response (FIR) modelling of the hemodynamic response was used to capture signal changes at word-level resolution. We found that spatial demonstratives bilaterally engage a network of parietal areas, including the supramarginal gyrus, the angular gyrus, and precuneus, implicated in information integration and visuospatial processing. Moreover, demonstratives recruit frontal regions, including the right FEF, implicated in attentional orienting and reference frames shifts. Finally, using multivariate similarity analyses, we provide evidence for a general involvement of the dorsal ("where") stream in the processing of spatial expressions, as opposed to ventral pathways encoding object semantics. Overall, our results suggest that language processing relies on a distributed architecture, recruiting neural resources for perception, attention, and extra-linguistic aspects of cognition in a dynamic and context-dependent fashion.

Transcranial Static Magnetic Field Stimulation Over the Temporal Cortex Modulating the Right Ear Advantage in Dichotic Listening

OBJECTIVE

Transcranial static magnetic field stimulation (tSMS) has proposed a new, promising, and simple non-invasive brain stimulation method. While several studies gained certain evidence about tSMS effects in the motor, somatosensory, and visual domains, there is still a controversial debate about its general effectiveness. In the present study, we investigated potential tSMS effects on auditory speech processing as measured by a dichotic listening (DL) task.

MATERIALS AND METHODS

Fifteen healthy participants received in randomized order on three different days one session of either sham, tSMS over the left, or tSMS over the right auditory cortex (AC). Under stimulation, participants performed a standard DL task with consonant-vowel syllables. Simultaneously, we recorded electroencephalogram from central sites (Fz, Cz, Pz).

RESULTS

TSMS over the left AC changed the behavioral performance and modulated auditory evoked potentials. Stimulation of the left AC significantly reduced the right ear advantage during the DL task and the N1 component of auditory evoked potentials in response to these syllables.

CONCLUSIONS

The preliminary results of the present exploratory study demonstrate the ability of tSMS to modulate human brain activity on a behavioral as well as physiologic level. Furthermore, tSMS effects on acoustic processing may have clinical implications by fostering potential approaches for a treatment of speech-related pathologies associated with hyperexcitability in the AC.

Electrophysiological characteristics in children with listening difficulties, with or without auditory processing disorder

Objective: To determine if the auditory middle latency responses (AMLR), auditory late latency response (ALLR) and auditory P300 were sensitive to auditory processing disorder (APD) and listening difficulties in children, and further to elucidate mechanisms regarding level of neurobiological problems in the central auditory nervous system. Design: Three-group, repeated measure design. Study sample: Forty-six children aged 8-14 years were divided into three groups: children with reported listening difficulties fulfilling APD diagnostic criteria, children with reported listening difficulties not fulfilling APD diagnostic criteria and normally hearing children. Results: AMLR Na latency and P300 latency and amplitude were sensitive to listening difficulties. No other auditory evoked potential (AEP) measures were sensitive to listening difficulties, and no AEP measures were sensitive to APD only. Moderate correlations were observed between P300 latency and amplitude and the behavioural AP measures of competing words, frequency patterns, duration patterns and dichotic digits. Conclusions: Impaired thalamo-cortical (bottom up) and neurocognitive function (top-down) may contribute to difficulties discriminating speech and non-speech sounds. Cognitive processes involved in conscious recognition, attention and discrimination of the acoustic characteristics of the stimuli could contribute to listening difficulties in general, and to APD in particular.

Intrinsic 40Hz-phase asymmetries predict tACS effects during conscious auditory perception

Synchronized oscillatory gamma-band activity (30-100Hz) has been suggested to constitute a key mechanism to dynamically orchestrate sensory information integration across multiple spatio-temporal scales. We here tested whether interhemispheric functional connectivity and ensuing auditory perception can selectively be modulated by high-density transcranial alternating current stimulation (HD-tACS). For this purpose, we applied multi-site HD-tACS at 40Hz bilaterally with a phase lag of 180° and recorded a 64-channel EEG to study the oscillatory phase dynamics at the source-space level during a dichotic listening (DL) task in twenty-six healthy participants. In this study, we revealed an oscillatory phase signature at 40Hz which reflects different temporal profiles of the phase asymmetries during left and right ear percept. Here we report that 180°-tACS did not affect the right ear advantage during DL at group level. However, a follow-up analysis revealed that the intrinsic phase asymmetries during sham-tACS determined the directionality of the behavioral modulations: While a shift to left ear percept was associated with augmented interhemispheric asymmetry (closer to 180°), a shift to right ear processing was elicited in subjects with lower asymmetry (closer to 0°). Crucially, the modulation of the interhemispheric network dynamics depended on the deviation of the tACS-induced phase-lag from the intrinsic phase asymmetry. Our characterization of the oscillatory network trends is giving rise to the importance of phase-specific gamma-band coupling during ambiguous auditory perception, and emphasizes the necessity to address the inter-individual variability of phase asymmetries in future studies by tailored stimulation protocols.

The supplementary motor area syndrome and cognitive control

The Supplementary Motor Area (SMA)-syndrome is a transient disturbance of the ability to initiate voluntary motor and speech actions that will often occur immediately after neurosurgical resections in the dorsal superior frontal gyrus but will typically have disappeared after 3 months. The purpose of the present study was to investigate the extent to which this syndrome is associated with alterations in cognitive control. Five patients who were to different extents affected by the SMA-syndrome after surgery for WHO grade II gliomas in the left hemisphere, were tested with the color word interference (Stroop) test; the Bergen dichotic listening test and for letter and category verbal fluency before surgery, 1-2 days after surgery and approximately 3 months after surgery. Results suggest that the motor symptoms known as the SMA syndrome co-occur with pronounced deficits in cognitive control.

Hemispheric specializations affect interhemispheric speech sound integration during duplex perception

The present study investigated whether speech-related spectral information benefits from initially predominant right or left hemisphere processing. Normal hearing individuals categorized speech sounds composed of an ambiguous base (perceptually intermediate between /ga/ and /da/), presented to one ear, and a disambiguating low or high F3 chirp presented to the other ear. Shorter response times were found when the chirp was presented to the left ear than to the right ear (inducing initially right-hemisphere chirp processing), but no between-ear differences in strength of overall integration. The results are in line with the assumptions of a right hemispheric dominance for spectral processing.

Auditive training effects from a dichotic listening app in children with dyslexia

Dichotic listening (DL) taps information on the brain's language laterality, processing, and attention. Research has shown that DL responses in dyslexia deviate from the typical pattern. Here, effects of DL training and its correspondence to rapid naming (RAN) and digit span (DS) in typical children and children with dyslexia were assessed. Three groups of third graders participated: two training groups, control training (CT) and dyslexia training (DT), and a control group that received no training (control no training, CnT). All took part in testing pretraining and posttraining. DL measures were on laterality, response scores, and attention. The three groups showed different response patterns: minor changes in CnT, change in all measures in CT, and some changes in DT. RAN and DS scores correlated significantly with some of the DL measures, especially with the attention scores. Our findings support arguments that brain architecture for language in dyslexia is lateralised in the same way as in children without dyslexia. However, the ability to modulate attention during DL is weaker in dyslexia than in typically developing children. A training-induced normalisation of lateralisation was observed in free recall in the dyslexia group, which suggests that DL training may be a promising intervention approach.

Development of perception and perceptual learning for multi-timescale filtered speech

The perception of temporally changing auditory signals has a gradual developmental trajectory. Speech is a time-varying signal, and slow changes in speech (filtered at 0-4 Hz) are preferentially processed by the right hemisphere, while the left extracts faster changes (filtered at 22-40 Hz). This work examined the ability of 8- to 19-year-olds to both perceive and learn to perceive filtered speech presented diotically for each filter type (low vs high) and dichotically for preferred or non-preferred laterality. Across conditions, performance improved with increasing age, indicating that the ability to perceive filtered speech continues to develop into adolescence. Across age, performance was best when both bands were presented dichotically, but with no benefit for presentation to the preferred hemisphere. Listeners thus integrated slow and fast transitions between the two ears, benefitting from more signal information, but not in a hemisphere-specific manner. After accounting for potential ceiling effects, learning was greatest when both bands were presented dichotically. These results do not support the idea that cochlear implants could be improved by providing differentially filtered information to each ear. Listeners who started with poorer performance learned more, a factor which could contribute to the positive cochlear implant outcomes typically seen in younger children.

Abnormal Resting-State Quantitative Electroencephalogram in Children With Central Auditory Processing Disorder: A Pilot Study

In this study, we showed an abnormal resting-state quantitative electroencephalogram (QEEG) pattern in children with central auditory processing disorder (CAPD). Twenty-seven children (16 male, 11 female; mean age = 10.7 years) with CAPD and no symptoms of other developmental disorders, as well as 23 age- and sex-matched, typically developing children (TDC, 11 male, 13 female; mean age = 11.8 years) underwent examination of central auditory processes (CAPs) and QEEG evaluation consisting of two randomly presented blocks of “Eyes Open” (EO) or “Eyes Closed” (EC) recordings. Significant correlations between individual frequency band powers and CAP tests performance were found. The QEEG studies revealed that in CAPD relative to TDC there was no effect of decreased delta absolute power (1.5–4 Hz) in EO compared to the EC condition. Furthermore, children with CAPD showed increased theta power (4–8 Hz) in the frontal area, a tendency toward elevated theta power in EO block, and reduced low-frequency beta power (12–15 Hz) in the bilateral occipital and the left temporo-occipital regions for both EO and EC conditions. Decreased middle-frequency beta power (15–18 Hz) in children with CAPD was observed only in the EC block. The findings of the present study suggest that QEEG could be an adequate tool to discriminate children with CAPD from normally developing children. Correlation analysis shows relationship between the individual EEG resting frequency bands and the CAPs. Increased power of slow waves and decreased power of fast rhythms could indicate abnormal functioning (hypoarousal of the cortex and/or an immaturity) of brain areas not specialized in auditory information processing.

The head turn paradigm to assess auditory laterality in cats: influence of ear position and repeated sound presentation

In most humans, speech is predominantly processed by the left hemisphere. This auditory laterality was formerly thought to be an exclusive human characteristic, but is now suggested to have pre-human origins. In studies on auditory laterality in nonhuman animals, the head turn paradigm has become very popular due to its non-invasive character. Although there are implications that the head turn direction indicates functional dominance of the contralateral hemisphere in processing a given sound, the validity of the paradigm is under debate. To validate the paradigm via comparison with imaging or electrophysiological methods, it is first necessary to establish turning biases at the individual level. Recently, the domestic cat, a common model in hearing research, has been found to show turning biases at the group level. To assess individual turning asymmetries in cats, we repeatedly presented kitten isolation calls and assessed whether differences in conveyed arousal changed the previously described left-wards lateralisation of conspecific vocalizations. Based on responses to 50 playback presentations (25 of high and 25 of low arousal), we calculated individual head turn indices. Based on the total data set, we found no consistent individual turning bias, irrespective of call category or sex of the receiver. Although the playback paradigm was chosen carefully to reduce any effects of lateralized loudness perception or changes in motivation due to habituation, individual head turn biases changed significantly in concordance with habituation to repeated playback-presentations and was predictable by small deflections in ear position prior to listening. When splitting the data set according to a decline in responsiveness after seven playback presentations, we revealed an initial left turning bias for most of our subjects (i.e., significant at the group level). We propose that this left turning bias is related to right hemisphere dominance in processes like vigilance behaviour or general arousal rather than on auditory processing, as such. Our findings suggest that both the experimental sequence and sound level differences, induced by asymmetric ear positions, strongly influence the outcome of the head turn paradigm and should be taken into account when evaluating auditory laterality at the behavioural level.

The performance of an automatic acoustic-based program classifier compared to hearing aid users' manual selection of listening programs

OBJECTIVE

To compare preference for and performance of manually selected programmes to an automatic sound classifier, the Phonak AutoSense OS.

DESIGN

A single blind repeated measures study. Participants were fit with Phonak Virto V90 ITE aids; preferences for different listening programmes were compared across four different sound scenarios (speech in: quiet, noise, loud noise and a car). Following a 4-week trial preferences were reassessed and the users preferred programme was compared to the automatic classifier for sound quality and hearing in noise (HINT test) using a 12 loudspeaker array.

STUDY SAMPLE

Twenty-five participants with symmetrical moderate-severe sensorineural hearing loss.

RESULTS

Participant preferences of manual programme for scenarios varied considerably between and within sessions. A HINT Speech Reception Threshold (SRT) advantage was observed for the automatic classifier over participant's manual selection for speech in quiet, loud noise and car noise. Sound quality ratings were similar for both manual and automatic selections.

CONCLUSIONS

The use of a sound classifier is a viable alternative to manual programme selection.

The effect of side of implantation on unilateral cochlear implant performance in patients with prelingual and postlingual sensorineural hearing loss: A systematic review

OBJECTIVE

Cerebral lateralisation of language processing leads to a right ear advantage in normal hearing subjects. The aim of this study was to present a systematic overview of the effect of implantation side on postoperative cochlear implant performance in patients with symmetrical severe to profound sensorineural hearing loss.

DATA SOURCES

PubMed, Embase and The Cochrane Library databases.

RESEARCH METHODS

Databases were searched from database inception up to 9 January 2017 for cochlear implant and side and all synonyms. Title, abstract and full-text of retrieved articles were screened for eligibility. Then, directness of evidence and risk of bias were assessed. For the included articles, study characteristics and outcome data (hearing and language development) were extracted.

RESULTS

2541 unique articles were screened, of which twenty were eligible for critical appraisal. No randomised controlled trials were identified. Twelve studies with a high directness of evidence remained for data extraction. Four of six studies including children with pre-lingual sensorineural hearing loss and four of seven studies investigating adults with postlingual sensorineural hearing loss found a right ear advantage in at least one outcome measurement related to cochlear implant performance.

CONCLUSION

The available evidence on the effect of side of implantation is of low quality, as study populations and outcome measures are heterogeneous. The majority of studies reveals evidence for a right ear advantage in prelingually deafened children as well as postlingually deafened adults. In view of the present evidence and as no left ear advantage was identified, we cautiously advise implanting the cochlear implant in the right ear when other prognostic factors do not favour the left ear and sensorineural hearing loss is symmetrical.